# Neurological Complications in a Patient With Thalassemia Intermedia and Chronic Myeloid Leukemia: A Case of Extramedullary Hematopoiesis-Induced Spinal Cord Compression

## TL;DR

A patient with two blood disorders developed spinal cord compression due to a rare condition called extramedullary hematopoiesis, highlighting the need for early diagnosis and multidisciplinary care.

## Contribution

This case report emphasizes the importance of recognizing EMH-induced spinal cord compression in patients with overlapping hematologic conditions.

## Key findings

- Extramedullary hematopoiesis can cause spinal cord compression in patients with thalassemia intermedia and chronic myeloid leukemia.
- Timely diagnosis and multidisciplinary management are crucial to prevent permanent neurological damage.
- Neurological symptoms in hematologic patients should prompt evaluation for EMH-related complications.

## Abstract

Extramedullary hematopoiesis (EMH) is a rare but significant compensatory response to chronic ineffective erythropoiesis, frequently seen in hematologic disorders such as thalassemia intermedia (TI) and chronic myeloid leukemia (CML). While EMH is typically asymptomatic, it can manifest as paraspinal masses that cause spinal cord compression, resulting in severe neurological deficits. This case highlights the complexities in managing overlapping hematologic conditions and emphasizes the importance of timely diagnosis and intervention. We present a 50-year-old male with a longstanding history of TI and CML, who developed progressive lower extremity weakness, gait instability, and sensory deficits due to spinal cord compression from EMH. This case underscores the critical need for clinical awareness and early intervention in patients with hematologic disorders who present with neurological symptoms. EMH-induced spinal cord compression, though rare, can lead to significant morbidity if left untreated. Multidisciplinary management involving neurology, hematology, radiology, and rehabilitation is essential to optimize outcomes and prevent permanent neurological deficits in affected patients.