The meningeal involvement is rare in
acute promyelocytic leukemia. We experienced a 39-year-old
woman who achieved complete remission with all-
trans retinoic acid,
idarubicin and
cytarabine therapy. Several months later, she complained of non-specific
headache. Her complete
blood cell count was normal, but
magnetic resonance image of
brain revealed focal meningeal enhancement and
cerebrospinal fluid showed leukemic
promyelocytes and PML/RARA rearrangement.
Bone marrow study showed hematologic,
cytogenetic and molecular remission. She was treated with intrathecal and systemic
chemotherapy and whole
brain radiotherapy. The
patient has survived for 68 months since the last systemic
chemotherapy.