Infiltration of central nervous system in chronic lymphocytic leuke-mia:case report and review of literature / 中国肿瘤临床

ABSTRACT

Objective:To explore the incidence, diagnosis, treatment, and prognosis of central nervous system (CNS) infiltration in chronic lymphocytic leukemia (CLL). Methods:One case with symptomatic CNS involvement reported dizziness, diplopia, and gen-eral fatigue as initial manifestations of CLL, as shown in a literature review. Results:Autopsy studies revealed that leukemic invasion of CNS was found in 8%to 71%of CLL patients, whereas incidence of leukemic infiltration in symptomatic CNS was approximately 1%. The complication did not correlate with any evident risk factors, and symptoms in patients with leukemic CNS infiltration were het-erogeneous and non-specific. Diagnosis of the disease depends on cerebrospinal fluid (CSF) cytology and flow cytometry. In most of similar cases, neurologic improvement is achieved by either intrathecal chemotherapy or radiation therapy. Failure to treat leukemic CNS infiltration leads to rapid deterioration and death. Conclusion:Leukemic involvement of the CNS is very rare in CLL cases and in-dicates poor prognosis. Prompt diagnosis and aggressive treatment are crucial for long-term remission and complete resolution of neuro-logical symptoms.