Diagnosis and Management of Leukemic and Lymphomatous Meningitis.
BACKGROUND
Leukemic and lymphomatous meningitis is a major presentation of primary or secondary central nervous system (CNS) involvement by aggressive lymphomas or acute leukemia.


METHODS
The medical literature and ongoing clinical trials were reviewed on the clinical presentation, diagnosis, prognosis, prevention, and treatment of leukemic and lymphomatous meningitis.


RESULTS
Treatment for secondary leukemic and lymphomatous meningitis remains unsatisfactory, and efforts should be made to prevent and treat subclinical disease. Intrathecal and systemic chemotherapy remain the main therapeutic approaches for this disease. Outcomes have improved in patients with primary CNS lymphoma and meningeal involvement.


CONCLUSIONS
Appropriate selection of patients at high risk for leukemic and lymphomatous meningitis is important so that preventive strategies can decrease the incidence of this complication of leukemia and lymphoma. Use of chemotherapy agents that cross the blood-brain barrier and the adoption of high-dose chemotherapy with autologous hematopoietic stem cell transplantation have increased the proportion of patients whose primary disease is cured.
University of South Florida Morsani College of Medicine, Tampa, FL.
Hemant
H
Murthy
University of South Florida Morsani College of Medicine and Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL.
Claudio
C
Anasetti
Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL. Ernesto.Ayala@Moffitt.org.
Ernesto
E
Ayala
D019468:Disease Management; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008223:Lymphoma / Q000150:complications*; D008581:Meningitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D011379:Prognosis