Chronic Lymphocytic Leukemia with Central Nervous System Involvement: Report of Two Cases with a Comprehensive Literature Review

Overview

Journal J Neurooncol

Publisher Springer

Date 2011 Jul 20

PMID 21769650

Citations 22

Authors

Alan A Moazzam

Jan Drappatz

Ryan Y Kim

Santosh Kesari

Affiliations

Soon will be listed here.

Abstract

Central nervous system (CNS) involvement is a rare complication of chronic lymphocytic leukemia (CLL) with varied outcomes. We contribute two additional cases of CLL with CNS involvement. The clinical course and response to treatment are described. All 78 previously reported cases of CLL with CNS involvement are presented in this comprehensive review of the literature. CNS involvement of CLL is a rare complication that does not seem to correlate with any evident risk factors. Resolution of CNS symptoms can often be accomplished with intrathecal chemotherapy or irradiation. Early detection and treatment may result in better outcomes in this rare complication.

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References

Staudt L . Molecular diagnosis of the hematologic cancers. N Engl J Med. 2003; 348(18):1777-85. DOI: 10.1056/NEJMra020067. View

Chiorazzi N, Rai K, Ferrarini M . Chronic lymphocytic leukemia. N Engl J Med. 2005; 352(8):804-15. DOI: 10.1056/NEJMra041720. View

Korsager S, Laursen B, Munck Mortensen T . Dementia and central nervous system involvement in chronic lymphocytic leukaemia. Scand J Haematol. 1982; 29(4):283-6. DOI: 10.1111/j.1600-0609.1982.tb00595.x. View

Lange C, Brouwer R, Brooimans R, Vecht C . Leptomeningeal disease in chronic lymphocytic leukemia. Clin Neurol Neurosurg. 2007; 109(10):896-901. DOI: 10.1016/j.clineuro.2007.07.021. View

Currie J, Lessell S, LESSELL I, Weiss J, Albert D, Benson E . Optic neuropathy in chronic lymphocytic leukemia. Arch Ophthalmol. 1988; 106(5):654-60. DOI: 10.1001/archopht.1988.01060130708030. View

Garofalo Jr M, Murali R, Halperin I, Magardician K, Moussouris H, Masdeu J . Chronic lymphocytic leukemia with hypothalamic invasion. Cancer. 1989; 64(8):1714-6. DOI: 10.1002/1097-0142(19891015)64:8<1714::aid-cncr2820640826>3.0.co;2-g. View

Lopez Guillermo A, Cervantes F, Blade J, Matutes E, Urbano A, Montserrat E . Central nervous system involvement demonstrated by immunological study in prolymphocytic variant of chronic lymphocytic leukemia. Acta Haematol. 1989; 81(2):109-11. DOI: 10.1159/000205537. View

Elliott M, Letendre L, Li C, Hoyer J, Hammack J . Chronic lymphocytic leukaemia with symptomatic diffuse central nervous system infiltration responding to therapy with systemic fludarabine. Br J Haematol. 1999; 104(4):689-94. DOI: 10.1046/j.1365-2141.1999.01245.x. View

Liepman M, Votaw M . Meningeal leukemia complicating chronic lymphocytic leukemia. Cancer. 1981; 47(10):2482-4. DOI: 10.1002/1097-0142(19810515)47:10<2482::aid-cncr2820471028>3.0.co;2-o. View

10.

Almhanna K, Wongchaowart N, Sweetenham J . Intracerebral Hodgkin's lymphoma in a patient with chronic lymphocytic leukemia/small lymphocytic lymphoma: a case report and literature review. Cancer Invest. 2009; 27(2):215-20. DOI: 10.1080/07357900802189824. View

11.

Conesa V, Mompel A, Ruiz J, Gomez A, Fernandez P, Lucas J . Fulminant brain lymphoid infiltration in a patient with chronic lymphocytic leukemia. Am J Hematol. 1999; 60(2):167-8. DOI: 10.1002/(sici)1096-8652(199902)60:2<167::aid-ajh18>3.0.co;2-w. View

12.

Getaz E, Miller G . Spinal cord involvement in chronic lymphocytic leukemia. Cancer. 1979; 43(5):1858-61. DOI: 10.1002/1097-0142(197905)43:5<1858::aid-cncr2820430539>3.0.co;2-e. View

13.

Schmidt-Hieber M, Thiel E, Keilholz U . Spinal paraparesis due to leukemic meningitis in early-stage chronic lymphocytic leukemia. Leuk Lymphoma. 2005; 46(4):619-21. DOI: 10.1080/14767050400029681. View

14.

Singh A, Thompson R . Leukaemic meningitis in chronic lymphocytic leukaemia. Acta Haematol. 1986; 75(2):113-5. DOI: 10.1159/000206098. View

15.

Davies G . Meningeal leukemia complicating chronic lymphocytic leukemia. Cancer. 1982; 50(3):605-6. View

16.

Robak T, Gora-Tybor J, Tybor K, Jamroziak K, Robak P, Kordek R . Richter's syndrome in the brain first manifested as an ischaemic stroke. Leuk Lymphoma. 2004; 45(6):1261-7. DOI: 10.1080/10428190310001638823. View

17.

Mahe B, Moreau P, Bonnemain B, Letortorec S, Menegali D, Bourdin S . Isolated Richter's syndrome of the brain: two recent cases. Nouv Rev Fr Hematol (1978). 1994; 36(5):383-5. View

18.

Pastor E, Grau E, Real E . Leukemic meningitis in a patient with B-cell prolymphocytic leukemia. Haematologica. 1997; 82(4):511-2. View

19.

Kuwabara H, Kanamori H, Takasaki H, Takabayashi M, Yamaji S, Tomita N . Involvement of central nervous system in prolymphocytoid transformation of chronic lymphocytic leukemia. Leuk Lymphoma. 2003; 44(7):1235-7. DOI: 10.1080/1042819031000079177. View

20.

Tefferi A, Phyliky R . A clinical update on chronic lymphocytic leukemia. I. Diagnosis and prognosis. Mayo Clin Proc. 1992; 67(4):349-53. DOI: 10.1016/s0025-6196(12)61551-1. View