[A case of acute lymphocytic leukemia relapsed as meningoradiculoneuropathy after bone marrow transplantation].
We report a 21-year-old woman who had acute lymphocytic leukemia with a relapse in the peripheral nervous system after bone marrow transplantation. She developed gait disturbance and numbness of the lower limb extremities, with gradual worsening. Neurological examination detected paraparesis associated with areflexia and stocking-type paresthesia. An examination of the cerebro-spinal fluid detected leukemicells. T2-weighted MRI of the lumbar spine showed multiple hyperintense signal lesions at the bodies of vertebra, spinous processes, and pedicles. Based on the diagnosis of recurrent acute lymphocytic leukemia with tumor infiltration to the meninges (meningeal leukemia), she received chemotherapy, after which her neurological symptoms and signs gradually improved. We would like to emphasize that neurological examination is important to detect CNS relapse in a patient with leukemia, even in hematological complete remission.
Iwanami
Hisatake
H
Department of Neurology, Dokkyo University School of Medicine.
Odaka
Masaaki
M
Hirata
Koichi
K
D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000209:etiology*; D010524:Peripheral Nervous System Neoplasms / Q000209:etiology*; D011129:Polyradiculoneuropathy / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012008:Recurrence