Bower J H, Hammack J E, McDonnell S K, Tefferi A
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Neurology. 1997 Feb;48(2):407-12. doi: 10.1212/wnl.48.2.407.
We performed a retrospective study to characterize the type, frequency, and timing of neurologic complications in patients with B-cell chronic lymphocytic leukemia (B-CLL). We reviewed 962 total charts with a median follow-up time of 57.5 months. There were 109 cases (11.3%) of neurologic complications, including 69 cases (7.2%) of herpes zoster infection, 17 cases (1.8%) of other opportunistic infection, 14 cases (1.5%) of treatment-related conditions, eight cases (0.8%) of direct leukemic involvement of neural tissue, and 1 case (0.1%) of intracranial hemorrhage. No cases of a non-zoster opportunistic infection presented in early-stage (Rai stage 0-2) B-CLL, and only one case of direct leukemic involvement of neural structures presented in early-stage B-CLL. Of the 25 cases of non-zoster or treatment-related complications, only 5 presented before 6 years from the initial B-CLL diagnosis. Three of these were in advanced-stage B-CLL, staging could not be determined in one, and one presented in early-stage B-CLL. We conclude that the overall neurologic complication rate of B-CLL is low, and that the Rai stage of the disease correlates best with the risk of developing neurologic complications. The occurrence of a related non-zoster neurologic complication in a patient with B-CLL stage 0-2 approaches 1:1,000.
我们进行了一项回顾性研究，以明确B细胞慢性淋巴细胞白血病（B-CLL）患者神经系统并发症的类型、发生率及发生时间。我们查阅了962份病历，中位随访时间为57.5个月。共有109例（11.3%）出现神经系统并发症，其中带状疱疹感染69例（7.2%），其他机会性感染17例（1.8%），治疗相关疾病14例（1.5%），神经组织白血病直接浸润8例（0.8%），颅内出血1例（0.1%）。早期（Rai分期0-2期）B-CLL患者中无非带状疱疹机会性感染病例，早期B-CLL患者中仅有1例神经结构白血病直接浸润病例。在25例非带状疱疹或治疗相关并发症中，仅有5例在B-CLL首次诊断后6年内出现。其中3例为晚期B-CLL，1例分期无法确定，1例为早期B-CLL。我们得出结论，B-CLL的总体神经系统并发症发生率较低，且疾病的Rai分期与发生神经系统并发症的风险最相关。0-2期B-CLL患者发生相关非带状疱疹神经系统并发症的概率接近1:1000。
