[Acute myelogenous leukemia with recurrence of the meningeal, spinal cord and the optic nerve infiltration with remission induction by Co therapy and maintained by intrathecal chemotherapy with Ommaya reservoir].
A 42-year-old woman was diagnosed as having acute myelogenous leukemia (M 2 of FAB classification) in May, 1985. Complete remission was achieved with the BHAC-DP therapy (BHAC, daunomycin and prednisolone). Whole skull irradiation and intra thecal chemotherapy were performed by way of prevention. In 1986, she developed her visual disturbance and paraplegia. Myelography and metrizamide CT indicate intraspinal and meningeal infiltration of leukemic cells in the upper thoracic spine. Leukemic cells were found in the cerebrospinal fluid but not in the bone marrow. Complete remission was obtained by irradiation and intrathecal chemotherapy. In Dec. 1986, Ommaya tubing was repeated. Hematological and neurological examinations showed no evidence of malignancy for 3 years. In Oct. 1988, she admitted to our hospital for the maintenance of the remission state, and died of sepsis. The result of autopsy revealed no leukemic cells in her CNS. It is said the intraspinal infiltration of leukemic cells is rather rare. As it is said the intrathecal injection of anti-leukemic agents is not effective for the intraspinal infiltration, irradiation should be needed. Therefore it is very important to critically differentiated intraspinal from meningeal infiltration. Furthermore, Ommaya tubing is effective in order to maintain remission in a patient with CNS leukemia.
Kurituka
H
H
Yokoo
K
K
Kishi
A
A
Mizuno
T
T
Kitani
K
K
Ozawa
M
M
Kobayashi
Y
Y
Takanashi
Y
Y
Horiuchi
H
H
Maruo
N
N
D000328:Adult; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003390:Cranial Nerve Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008577:Meningeal Neoplasms / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D009900:Optic Nerve; D013120:Spinal Cord Neoplasms / Q000628:therapy*
D003037:Cobalt Radioisotopes