Leukemia
Leukemia
Pediatric spinal leukemia refers to the involvement of the spinal cord and surrounding structures by leukemic cells in children diagnosed with leukemia, particularly acute lymphoblastic leukemia (ALL) and, less commonly, acute myeloid leukemia (AML). Although leukemia primarily affects the bone marrow and blood, infiltration of the spine can lead to serious neurological complications requiring prompt diagnosis and multidisciplinary management. In Bangladesh, timely recognition and specialized care of spinal involvement in pediatric leukemia patients remain a significant challenge. Dr. Md. Nafaur Rahman provides expert neurosurgical evaluation and intervention, working closely with pediatric oncologists to optimize outcomes for affected children. What is Pediatric Spinal Leukemia? Leukemia is a malignant proliferation of immature white blood cells (blasts) in the bone marrow and blood. When leukemic cells infiltrate the spinal canal, they can cause: Leptomeningeal disease – infiltration of the meninges surrounding the spinal cord Spinal cord compression – due to extramedullary masses or infiltration Vertebral bone involvement – causing bone destruction or pathological fractures Spinal leukemia may present as a complication at diagnosis or relapse, and requires careful neurological assessment. Causes and Risk Factors Pediatric leukemia (mainly ALL) can involve the central nervous system (CNS) and spine either initially or during treatment relapse Risk factors include certain genetic mutations and initial high white blood cell counts CNS prophylaxis with chemotherapy and/or radiotherapy reduces but does not eliminate risk In Bangladesh, challenges include late diagnosis and limited access to comprehensive leukemia care Clinical Symptoms Spinal involvement in pediatric leukemia may manifest as: Back or neck pain Limb weakness or paralysis Sensory disturbances such as numbness or tingling Bladder or bowel dysfunction Spinal deformity or tenderness over vertebrae Symptoms of systemic leukemia like fatigue, fever, and bleeding may also be present Early recognition is critical to prevent permanent neurological damage. Diagnostic Approach Accurate diagnosis involves a combination of clinical evaluation and imaging studies: Neurological examination focusing on motor and sensory deficits MRI of the spine with contrast is the gold standard to detect spinal cord involvement, leptomeningeal spread, and vertebral lesions CSF analysis through lumbar puncture to detect leukemic cells in the cerebrospinal fluid Bone marrow biopsy and peripheral blood tests confirm systemic leukemia diagnosis Treatment Strategies in Bangladesh Management of pediatric spinal leukemia is complex and requires coordination between pediatric neurosurgeons, oncologists, radiologists, and rehabilitation teams. Neurosurgical Interventions by Dr. Md. Nafaur Rahman Surgery is usually reserved for decompression of the spinal cord in cases of severe neurological compromise Biopsy may be needed for diagnosis in ambiguous cases Spinal stabilization surgeries are considered if vertebral destruction causes instability Surgery is followed by chemotherapy and/or radiotherapy Medical Treatment Systemic chemotherapy tailored for leukemia Intrathecal chemotherapy for CNS prophylaxis and treatment Radiotherapy in selected cases for CNS and spinal disease control Prognosis and Follow-Up Prognosis depends on leukemia subtype, CNS involvement extent, and response to therapy Early intervention improves neurological recovery and overall survival Long-term follow-up is critical for monitoring relapse and managing treatment side effects Rehabilitation and supportive care help improve quality of life Challenges in Bangladesh Limited awareness of spinal leukemia manifestations among primary care providers Difficulty accessing MRI and pediatric oncology services outside major cities Socioeconomic barriers impacting timely diagnosis and treatment adherence Need for expanded multidisciplinary care centers specializing in pediatric oncology and neurosurgery Why Choose Dr. Md. Nafaur Rahman? Expert pediatric neurosurgeon skilled in spinal tumor and lesion management Affiliated with National Institute of Neurosciences & Hospital (NINS), Bangladesh’s premier neurosurgical center Chief Consultant at Bangladesh Paediatric Neurocare Centre dedicated to children’s neurological health Collaborative approach with pediatric oncologists for integrated leukemia care Committed to raising awareness and improving outcomes for pediatric spinal leukemia in Bangladesh Contact and Appointment Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Appointment / Serial: 📱 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com
