López Guillermo A, Cervantes F, Bladé J, Matutes E, Urbano A, Montserrat E, Rozman C
Postgraduate School of Hematology Farreras Valentí, University of Barcelona, Spain.
Acta Haematol. 1989;81(2):109-11. doi: 10.1159/000205537.
A patient with the prolymphocytic variant of B cell chronic lymphocytic leukemia (CLL/PL) who developed meningeal leukemic involvement is reported. He had been diagnosed as having CLL/PL 2.5 years earlier, and treated successively with splenectomy, continuous chlorambucil and CHOP chemotherapy. While receiving the latter treatment, the patient developed persistent cephalalgia and vomiting, without signs of neurological focality. A lumbar puncture yielded a cerebrospinal fluid (CSF) showing lymphoid cells of prolymphocytic appearance and the immunological cell markers demonstrated the clonality of these cells. Intrathecal methotrexate and arabinosyl cytosine treatment was administered, this leading to the disappearance of the abnormal cells from the CSF and the resolution of the clinical symptoms.
报告了1例发生脑膜白血病浸润的B细胞慢性淋巴细胞白血病（CLL/PL）前淋巴细胞变异型患者。他于2.5年前被诊断为CLL/PL，先后接受了脾切除术、持续苯丁酸氮芥和CHOP化疗。在接受后一种治疗时，患者出现持续性头痛和呕吐，无神经定位体征。腰椎穿刺获得的脑脊液（CSF）显示前淋巴细胞样淋巴细胞，免疫细胞标志物证实这些细胞具有克隆性。给予鞘内甲氨蝶呤和阿糖胞苷治疗，这导致CSF中异常细胞消失，临床症状缓解。
