A relapse of acute lymphoblastic leukemia (ALL) can present with central nervous system (CNS) involvement.


Patient selection: ALL in remission


Relapse in the CNS may be indicated by one or more of the following:

(1) development of CNS-3 status (CSF WBC >= 5 per µL with lymphoblasts present)

(2) facial nerve palsy

(3) eye involvement

(4) brain involvement (headache, etc)

(5) hypothalamic syndrome


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