Brick W G, Majmundar M, Hendricks L K, Kallab A M, Burgess R E, Jillella A P
Section of Hematology/Oncology, Medical College of Georgia, Augusta 30912, USA.
Leuk Lymphoma. 2002 Jan;43(1):199-201. doi: 10.1080/10428190210191.
Central nervous system (CNS) involvement in early (Rai Stage 0 and Stage 1) chronic lymphocytic leukemia (CLL) is rare, with only five cases reported. We present the sixth reported case, a 77-year-old male with a 4 year history of Stage 0 CLL who presented with sudden onset of diplopia and headache. Workup revealed a leukemic involvement of his CNS and he responded well to treatment with intrathecal (IT) methotrexate. After his third IT treatment, he developed a change in his mental status, consistent with a chemotherapy induced encephalopathy, which was effectively treated with IT hydrocortisone. In addition to the case presentation, we review the previously reported cases in an effort to determine any characteristics common among the Stage 0/1 CLL patients with reported CNS involvement.
中枢神经系统（CNS）受累于早期（Rai 0期和1期）慢性淋巴细胞白血病（CLL）较为罕见，仅报告过5例。我们现报告第6例，一名77岁男性，有4年0期CLL病史，表现为突发复视和头痛。检查发现其CNS有白血病浸润，鞘内注射甲氨蝶呤治疗反应良好。在第三次鞘内注射治疗后，他出现精神状态改变，符合化疗所致脑病，鞘内注射氢化可的松治疗有效。除了病例报告外，我们还回顾了既往报告的病例，以确定0/1期CLL且有CNS受累报告的患者之间的任何共同特征。
