[Methotrexate resistance in acute lymphatic leukemia treated intrathecally].

During intrathecal methotrexate therapy of meningeal manifestations of acute lymphatic leukemia, renewed occurrence of lymphoblasts in the cerebrospinal fluid cell picture developed in two women. Prompt clearance could be attained by application of cytosine arabinoside. Methotrexate-resistance as one reason is discussed. The value of differentiated cerebrospinal fluid cell investigations for diagnosis and treatment of meningeal leukemia is pointed out. Neuralgic pain syndrome due to neoplastic neuropathy by direct infiltration of peripheral nerves are discussed, therapeutic measures pointed out.