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Leptomeningeal involvement in chronic lymphocytic leukemia
C Morrison1, S Shah, I W Flinn
1The Johns Hopkins University School of Nursing, Baltimore, MD, USA.
Cancer Practice
|October 10, 1998
Summary
Leptomeningeal involvement is a rare complication of chronic lymphocytic leukemia (CLL). Early diagnosis and prompt central nervous system-directed chemotherapy can improve patient outcomes.
Area of Science:
- Neurology
- Hematology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia.
- Central nervous system (CNS) invasion is an uncommon but serious complication of CLL.
- Only 21 cases of CNS involvement in CLL have been previously reported.
Observation:
- A 61-year-old man with asymptomatic CLL developed ataxia, vertigo, and headaches.
- Symptoms appeared 4 weeks after CLL diagnosis.
- Diagnosis was confirmed by clonal lymphocytes in cerebrospinal fluid.
Findings:
- The patient received radiation therapy to the head and neck and intrathecal methotrexate.
- Complete symptom resolution was achieved.
- No additional systemic chemotherapy was required.
Implications:
- CNS invasion in CLL may be underdiagnosed due to its rarity and nonspecific symptoms.
- Clinicians should consider CNS involvement in CLL patients with neurological symptoms.
- Timely diagnosis and CNS-directed treatment can positively impact morbidity and quality of life.