Hospital Santo António dos Capuchos - CHLC, Lisboa, Portugal.
Clin Lymphoma Myeloma Leuk. 2012 Jun;12(3):164-79. doi: 10.1016/j.clml.2011.10.005. Epub 2011 Dec 21.
Neurologic disease is believed to be an unusual complication during the course of chronic lymphocytic leukemia. Nevertheless, it has already been proven in autopsy series that the incidence of occult nervous system infiltration is much higher than was previously expected. The advent of more potent drugs to treat this lymphoproliferative disorder has brought a new hope for a possible cure in the future. However, an appropriate systemic treatment for central nervous system infiltration of this disease is still lacking. Also, due to the potent immunosuppressive properties of the agents used in the up-front treatment, for example, the purine nucleoside analogues, we have witnessed an increase in the incidence of opportunistic infections, with progressive multifocal leukoencephalopathy being one of the most serious. The goal of this review is to summarize the spectrum of neurologic derangements linked to chronic lymphocytic leukemia and to raise clinicians' awareness to recognize the possibility of such associations.
神经病变被认为是慢性淋巴细胞白血病病程中的一种不常见并发症。然而，尸检系列已经证明，隐匿性神经系统浸润的发生率远高于先前预期。更有效的药物治疗这种淋巴增生性疾病的出现，为未来的可能治愈带来了新的希望。然而，针对这种疾病的中枢神经系统浸润，仍然缺乏适当的全身治疗方法。此外，由于一线治疗中使用的药物具有很强的免疫抑制作用，例如嘌呤核苷类似物，我们已经看到机会性感染的发病率增加，进行性多灶性白质脑病是其中最严重的一种。本综述的目的是总结与慢性淋巴细胞白血病相关的神经功能障碍谱，并提高临床医生识别这种关联的可能性。
