Acalabrutinib and Obinutuzumab for Chronic Lymphocytic Leukemia Complicated With Peripheral Neuropathy

A 40-year-old man presented to our hospital with subacute progressive muscle weakness in the limbs and leukocytosis. Subsequently, the patient was diagnosed with chronic lymphocytic leukemia (CLL) complicated by peripheral motor neuron neuropathy (axonopathy). Serology test for anti-ganglioside GM2 IgG antibody was positive, whereas paraneoplastic syndrome-related and anti-myelin-associated glycoprotein antibodies were not detected. There was no evidence of advanced-stage CLL. Intravenous immunoglobulin and steroid pulse therapy were initiated with slight symptom amelioration. Acalabrutinib and obinutuzumab were administered, and his symptoms gradually improved. Hence, acalabrutinib and obinutuzumab may have been active in patients with CLL complicated by peripheral neuropathy.