Neurologic Complications of Lymphoma and Leukemia

Lymphoma and leukemia are systemic diseases that affect many end-organs, including the central nervous system. These cancers may directly affect the central or peripheral nervous systems by the production of intraparenchymal or extra-axial mass lesions or by meningeal infiltration. Vascular occlusion may occur as a result of blockage of blood vessels by tumor cells. A variety of paraneoplastic syndromes occur and are most commonly associated with plasma cell tumors. Coagulopathy and metabolic disturbances are direct and indirect effects of these cancers and also are associated with their treatment, resulting in disturbances of consciousness, intracranial hemorrhage, or ischemic stroke. The agents used in the treatment of lymphoma and leukemia are also associated with neurological toxicity. This chapter reviews these neurological manifestations of lymphoma and leukemia and their therapies.