Refractory Chronic Lymphocytic Leukemia with Central Nervous System Involvement: A Case Report with Literature Review.
central nervous system involvement
chronic lymphocytic leukemia
literature review
Journal
Journal of blood medicine
ISSN: 1179-2736
Titre abrégé: J Blood Med
Pays: New Zealand
ID NLM: 101550884
Informations de publication
Date de publication:
2020
2020
Historique:
received:
14
10
2020
accepted:
16
11
2020
entrez:
31
12
2020
pubmed:
1
1
2021
medline:
1
1
2021
Statut:
epublish
Résumé
There have been few reports on central nervous system (CNS) involvement in chronic lymphocytic leukemia (CLL). This is an extremely rare disease with poor prognosis, owing to resistance to various treatments. We describe a 33-year-old man with intractable CLL with CNS involvement. He was diagnosed with CLL, with diplopia as the first manifestation. Magnetic resonance imaging revealed a contrast-enhancing tumor in the right temporal lobe, which was diagnosed as CNS involvement in CLL on brain biopsy. High-dose methotrexate therapy was ineffective for this lesion, which was also resistant to subsequent whole-brain irradiation, treatment with fludarabine-cyclophosphamide-rituximab chemoimmunotherapy, and ibrutinib administration. Because no standard protocol exists for CLL with CNS involvement, it is important to accumulate case data to verify the choice of new drugs for administration at an early stage. Therefore, we also conducted a literature review of 50 case reports of CNS lesions in the last 10 years to consider the pathophysiology, diagnosis, and treatment of CNS involvement in CLL. The possibility of new therapeutic agents, eg, ibrutinib and venetoclax, or a combination of these agents and methotrexate, can be envisioned as a treatment strategy for CLL with CNS involvement.
Identifiants
pubmed: 33380856
doi: 10.2147/JBM.S271335
pii: 271335
pmc: PMC7767717
doi:
Types de publication
Case Reports
Langues
eng
Pagination
487-502Informations de copyright
© 2020 Nakanishi et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
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