B cell chronic lymphocytic leukemia with meningeal infiltration by T lymphocytes

Remková, Anna; Bezayová, Tatiana; Vyskočil, Milan

doi:10.1016/s0953-6205(02)00207-8

Cited by 15 publications

(4 citation statements)

References 10 publications

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“…A wide range of therapeutic modalities have been reported in sporadic cases (Stagg & Gumbart, 1987;Garicochea et al, 1997;Hagberg et al, 1997;Miller et al, 1997;Elliott et al, 1999;Poplawska-Szczyglowska et al, 1999;Rye et al, 2001;Brick et al, 2002;Remkov a et al, 2003;Knop et al, 2005;Mowatt et al, 2005;Watanabe et al, 2005;Hanse et al, 2008;Kakimoto et al, 2010;Cohen et al, 2012;Imitola et al, 2012;Moazzam et al, 2012;Strati et al, 2016), consisting of either IT, systemic immuno-chemotherapy or radiotherapy, combined or alone. Based on our results, FCR or BR with IT in first line seems an effective therapy, both for non-progressive and progressive CLL.…”

Section: Discussionmentioning

confidence: 99%

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

et al. 2016

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SummaryCentral nervous system involvement (CNSi) is a rare and poorly reported complication of chronic lymphocytic leukaemia (CLL). Establishing cause and effect between the CLL and the neurological symptoms remains challenging. We have analysed a retrospective cohort of 30 CLL patients with CNSi, documented by lymphocytic infiltration either by flow cytometry of the cerebrospinal fluid (CSF; n = 29) or CNS biopsy (n = 1). Neurological symptoms were heterogeneous. At the time of CNSi, less than half of the patients had a progressive CLL and 20 had never been treated for CLL. Initial treatment with fludarabine-based immuno-chemotherapy, with or without intra-CSF therapy, led to durable response in eight out of nine untreated patients. In contrast, 50% patients receiving various prior treatments needed additional therapy within a median of 4 months (1-16). Ibrutinib led to complete response in 4/4 heavily pre-treated patients. From CNSi, 5-year overall survival was 72% and 48% for treatment-na€ ıve and previously treated patients respectively (P = 0Á06); 5-year progression-free survival (PFS) was 43% and 0% (P = 0Á125). 17p deletion was significantly associated with poor PFS (P = 0Á006). CNSi may be the only sign of progression of CLL and should be considered an initiation criterion of systemic treatment. Prognosis seemed to be related to CLL characteristics rather than to CNSi itself.

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Section: Discussionmentioning

confidence: 99%

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

et al. 2016

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“…To our knowledge, no case of chronic lymphocytic leukemia with PLE has been described so far. One case of T-cell pleocytosis in the CSF in a patient with B-CLL who suffered from progressive somnolence and blurred vision has been reported [9]. According to the case report, no MRI was performed neither had the autoantibodies been tested.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Paraneoplastic Limbic Encephalitis after Systemic Treatment with Rituximab in a Patient with B-Cell Chronic Lymphocytic Leukemia

Nogai

Israel-Willner

Zschenderlein

et al. 2013

Case Reports in Hematology

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Limbic encephalitis is an inflammatory disease of the central nervous system characterized by diverse neurologic symptoms including mnestic disturbances, hallucinations, and seizures as well as behavioral symptoms like depression, personality changes, and acute confusional states resembling dementia. Several antibodies have been described in the pathogenesis of limbic encephalitis. It is often a paraneoplastic syndrome associated with small cell lung cancer, breast cancer, or Hodgkin's lymphoma among others. Here, we report a patient with B-cell chronic lymphocytic leukemia (B-CLL), presenting with otherwise unexplained neurologic symptoms consistent with limbic encephalitis. Despite intensive diagnostic procedures, no causing agent could be identified. Pleocytosis consisting of T cells was detected in the cerebrospinal fluid (CSF). We initiated anti-B-cell therapy with Rituximab for B-CLL with quick and durable resolution of symptoms. We speculate that disruption of interaction between autoreactive T and malignant B cells is responsible for the therapeutic effect of Rituximab.

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“…1,4,5 Intrathecal steroids were used to treat the chemotherapy-induced encephalopathy. 2,5,7 Rituximab was reported to be effective in a case refractory to the conventional chemotherapy. 7 Fludarabine also was suggested to be helpful in inducing durable remission in patients with leptomeningeal involvement of CLL.…”

Section: Discussionmentioning

confidence: 99%

“…2,5,7 Rituximab was reported to be effective in a case refractory to the conventional chemotherapy. 7 Fludarabine also was suggested to be helpful in inducing durable remission in patients with leptomeningeal involvement of CLL. 8 The present case illustrated that a complete resolution of the leukemic meningitis associated with CLL is attainable with intrathecal methotrexate with no adverse neurologic sequelae.…”

Section: Discussionmentioning

confidence: 99%

Leukemic Meningitis in Chronic Lymphocytic Leukemia

Esber¹,

Schulz²

2009

kjm

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B cell chronic lymphocytic leukemia with meningeal infiltration by T lymphocytes

Cited by 15 publications

References 10 publications

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

Improvement of Paraneoplastic Limbic Encephalitis after Systemic Treatment with Rituximab in a Patient with B-Cell Chronic Lymphocytic Leukemia

Leukemic Meningitis in Chronic Lymphocytic Leukemia

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