Spectrum of Movement Disorders in Hematological Malignancies: A Comprehensive Systematic Review of Clinical Phenotypes, Mechanisms, and Outcomes

TL;DR

This study reviews how different types of blood cancers are linked to specific movement disorders, helping guide diagnosis and treatment.

Contribution

The paper provides a systematic review of movement disorder patterns specific to different hematologic malignancies.

Findings

Lymphoid malignancies are most commonly associated with cerebellar ataxia and CNS involvement.

Myeloid disorders show hyperkinetic movement profiles like chorea, with rare CNS structural disease.

Plasma-cell neoplasms are characterized by parkinsonism and cerebellar syndromes.

Abstract

Movement disorders associated with hematologic malignancies remain incompletely defined. This review synthesized published articles to clarify clinical patterns, mechanisms, and outcomes across hematologic malignancies.

A PRISMA-compliant systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify reports describing movement disorders associated with hematologic malignancies. Eligible reports were screened according to predefined criteria, and data were extracted on demographics, hematologic diagnosis, central nervous system (CNS) involvement, movement-disorder phenotype, investigative findings, treatments administered, and neurological outcomes.

A total of 252 cases were included: 152 lymphoid, 78 myeloid, and 22 plasma-cell neoplasms. Lymphoid malignancies most commonly presented with cerebellar ataxia (55.3 percent), followed by parkinsonism (18.4 percent) and chorea (11.8 percent), with CNS involvement frequent, including infiltration (33.6 percent) and immune-mediated injury (30.3 percent). Myeloid disorders showed a predominantly hyperkinetic profile, especially generalized chorea (41 percent) and hemichorea or hemiballismus (17.9 percent), while structural CNS disease was rare (2.6 percent) and most cases reflected systemic or treatment-related mechanisms. Plasma-cell neoplasms were characterized mainly by parkinsonism (45.5 percent) and cerebellar syndromes (27.3 percent). Neurological improvement occurred in most patients, particularly after treatment of underlying hematologic disorder. In a cohort of 232 CNS lymphoma patients, prodromal neuropsychiatric features occurred in 9 percent, parkinsonism in 25 percent of those, and 80 percent improved following lymphoma-directed therapy.

Movement disorders in hematologic cancers show distinct, disease-specific profiles, with cerebellar, hyperkinetic, and parkinsonian patterns corresponding to lymphoid, myeloid, and plasma-cell neoplasms. CNS involvement mechanisms differ, providing essential diagnostic and therapeutic guidance.

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