Chronic Lymphocytic Leukemia with Leptomeningeal InvolvementBharath V and Hsia CC*
Department of Medicine, Division of Hematology, Western University & London Health Sciences Centre, London, Ontario, Canada
- *Corresponding Author:
- Cyrus C Hsia
Department of Medicine
Division of Hematology
London Health Sciences Centre Room, E6-219A
Victoria Hospital, 800 Commissioners Road
East London, Ontario, N6A 5W9, Canada
Tel: +519- 685-8500
E-mail: [email protected]
Received date: August 10, 2016; Accepted date: August 15, 2016; Published date: August 28, 2016
Citation: Bharath V, Hsia CC (2016) Chronic Lymphocytic Leukemia with Leptomeningeal Involvement. Chemo Open Access 5:I102. doi: 10.4172/2167-7700.1000I102
Copyright: © 2016 Bharath V, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
An 80 year old woman with chronic lymphocytic leukemia (CLL) developed lymphocytosis with symptomatic anemia and axillary lymphadenopathy two years after her diagnosis. Her white count was 27.9 × 109/L with a lymphocyte count of 4.185 × 109/L and hemoglobin 89 g/L. Initial flow cytometric immunophenotyping confirmed a monoclonal B-cell population positive for CD19/CD5, dim CD20, CD23, and expressing dim kappa light chains. Repeat peripheral blood flow cytometry revealed the same monoclonal B-cell population, and an axillary node biopsy was consistent with CLL. Chlorambucil was initiated, but discontinued after two cycles due to multiple side effects. A month later, the patient presented with acute onset upper extremity weakness. A lumbar puncture and examination of cerebrospinal fluid revealed a mixed population of pleomorphic lymphocytes with the same immunophenotype as the peripheral blood lymphocytes (Figure 1), revealing leptomeningeal involvement of CLL. Given the poor prognosis, the decision was made to proceed with palliation, and the patient passed away peacefully.