Pippard M J, Callender S T, Sheldon P W
Br Med J. 1979 Jan 27;1(6158):227-9. doi: 10.1136/bmj.1.6158.227.
Out of 64 consecutive unselected patients with acute myeloid leukaemia studied during 1973-6, five developed clinical evidence of spread to the central nervous system (CNS). Neuroradiological examination showed cerebral deposits in three, in whom rapid symptomatic relief was obtained with radiotherapy. In two of these patients who developed solid intracranial deposits haematological remission could be reinduced or maintained; they were still alive 86 and 134 weeks later. When patients presented with spread to the CNS complicating generalised uncontrolled leukaemia they had short survivals. CNS infiltration may respond dramatically to appropriate treatment provided that it is not associated with generalised uncontrolled leukaemia, which has a poor prognosis. In view of this, routine "prophylaxis" of the CNS in adult acute myeloid leukaemia does not seem justified at present.
在1973年至1976年期间研究的64例未经挑选的急性髓系白血病患者中，有5例出现了扩散至中枢神经系统（CNS）的临床证据。神经放射学检查显示3例有脑内沉积，对这3例患者进行放射治疗后症状迅速缓解。在这2例出现颅内实体性沉积的患者中，血液学缓解得以再次诱导或维持；86周和134周后他们仍存活。当患者出现扩散至中枢神经系统并使全身性白血病无法控制时，其生存期较短。如果中枢神经系统浸润不伴有预后不良的全身性白血病无法控制，那么对其进行适当治疗可能会有显著反应。鉴于此，目前对成人急性髓系白血病进行中枢神经系统的常规“预防性”治疗似乎没有道理。
