ArticleBlood advances2021
CNS involvement in AML at diagnosis is rare and does not affect response or survival: data from 11 ECOG-ACRIN trials.
Article in Blood advances, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Technological features of blast identification in the cerebrospinal fluid: A systematic review of flow cytometry and laboratory haematology methods.International journal of laboratory hematology · 2022Pooled it
- Flow cytometric detection of isolated central nervous system relapse in acute myeloid leukemia under FLT3-targeted therapy.Journal of hematopathology · 2026Article
- Cathepsin G is associated with cerebral vascular injury in myeloid leukemia: a pathologic insight into intracranial hemorrhage.Research and practice in thrombosis and haemostasis · 2026Article
- Central Nervous System Involvement in Acute Myeloid Leukemia: From Pathophysiology to Neuroradiologic Features and the Emerging Role of Artificial Intelligence.Journal of clinical medicine · 2026Review
- Gilteritinib in an Isolated CNS Recurrence of FLT3-ITD Positive AML.Clinical case reports · 2026Article
- Unraveling Intractable Headache in Acute Myeloid Leukemia With Coexisting Migraines and Chiari Malformation.Cureus · 2025Article
- Therapeutics of acute myeloid leukemia with central nervous system involvement.Clinical hematology international · 2025Article
- Isolated central nervous system relapse in acute myeloid leukemia: a case report and review of therapeutic challenges.Frontiers in oncology · 2025Article
- Central nervous system relapse after allogeneic HCT in FLT3-mutated AML.Annals of hematology · 2024Article
- Routes and molecular mechanisms of central nervous system involvement in acute myeloid leukemia (Review).Oncology reports · 2024Review
- Cells and signals of the leukemic microenvironment that support progression of T-cell acute lymphoblastic leukemia (T-ALL).Experimental & molecular medicine · 2024Review
- Myeloid sarcoma with maxillary gingival swelling as the initial symptom: A case report and review of literature.World journal of clinical cases · 2024Article
- Revisiting intrathecal thiotepa: Efficacy and safety in secondary CNS malignancies.Medical oncology (Northwood, London, England) · 2024Review
- Favorable pharmacokinetic and pharmacodynamic properties of gilteritinib in cerebrospinal fluid: a potential effective treatment in relapsing meningeal acute myeloid leukemiaHaematologica · 2023Article
- Central Nervous System Prophylaxis and Treatment in Acute Leukemias.Current treatment options in oncology · 2022Review
- Molecular profiling and clinical implications of patients with acute myeloid leukemia and extramedullary manifestations.Journal of hematology & oncology · 2022Article
- Central Nervous System Involvement in Adults with Acute Leukemia: Diagnosis, Prevention, and Management.Current oncology reports · 2022Review
Corrections and comments
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Authors and funding
12 authors at 12 institutions in 2 countries.
Funding
Abstract
Central nervous system (CNS) involvement in patients with newly diagnosed acute myeloid leukemia (AML) is rare, and systematic data regarding outcome are scarce. This retrospective study summarized data from 11 consecutive Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) clinical trials for patients with newly diagnosed AML. In all, 3240 patients with AML were analyzed, and 36 (1.11%) were found to have CNS involvement at diagnosis. The incidence of CNS disease among the 5 studies with per protocol mandatory lumbar puncture (LP) was similar to the incidence among studies in which LP was performed at the discretion of the investigator (0.86% vs 1.41%; P = .18). There was no significant difference in the rate of complete remission (CR) among patients with CNS involvement and those with other extramedullary disease (EMD) sites or those with no EMD (52.8% vs 59.3%-60%). The median overall survival (OS) for patients who were CNS positive, who had other EMD, or who had no EMD was 11.4, 11.3, and 12.7 months, respectively. There was no difference in OS among patients with CNS involvement, those with other EMD (hazard ratio [HR], 0.96; adjusted P = .84), and those with no EMD (HR, 1.19; adjusted P = .44). In conclusion, the reported incidence of CNS involvement in patients with newly diagnosed AML is low (1.1%), irrespective of whether an LP is mandatory or not. The presence of CNS disease at diagnosis in and of itself does not seem to portend a poor prognosis for achieving an initial CR or for OS.
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