Hoffman M A, Valderrama E, Fuchs A, Friedman M, Rai K
Department of Medicine, Albert Einstein College of Medicine, New Hyde Park, New York.
Cancer. 1995 Mar 1;75(5):1100-3. doi: 10.1002/1097-0142(19950301)75:5<1100::aid-cncr2820750508>3.0.co;2-q.
Leukemic meningitis is rare in B-chronic lymphocytic leukemia (CLL) and B-prolymphocytic leukemia (PLL); a MEDLINE search for reports published 1960 and after disclosed only nine prior reports. A patient with stable Rai Stage II CLL/PL developed mental status changes. Lumbar puncture revealed a lymphocytic pleocytosis with prolymphocytes containing intracytoplasmic inclusions.
The patient's cerebrospinal fluid lymphocyte population was analyzed by immunophenotyping and electron microscopy.
The studies revealed a clonal population of B prolymphocytes, with typical immunophenotypic and ultrastructural characteristics. The patient was treated with intrathecal chemotherapy with eventual resolution of the cerebrospinal fluid pleocytosis and return to his normal neurologic status. Prior studies also have revealed the efficacy of intrathecal chemotherapy.
Leukemic meningitis in CLL or PLL is responsive to treatment with intrathecal chemotherapy.
白血病性脑膜炎在B细胞慢性淋巴细胞白血病（CLL）和B细胞幼淋巴细胞白血病（PLL）中较为罕见；对1960年及以后发表在医学文献数据库（MEDLINE）上的报告进行检索，仅发现9篇既往报告。一名处于稳定的Rai II期CLL/PL患者出现了精神状态改变。腰椎穿刺显示淋巴细胞增多，其中幼淋巴细胞含有胞质内包涵体。
通过免疫表型分析和电子显微镜对患者的脑脊液淋巴细胞群体进行分析。
研究发现了一群克隆性的B幼淋巴细胞，具有典型的免疫表型和超微结构特征。患者接受了鞘内化疗，最终脑脊液淋巴细胞增多症得到缓解，神经系统恢复正常状态。既往研究也显示了鞘内化疗的有效性。
CLL或PLL中的白血病性脑膜炎对鞘内化疗有反应。
