This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal

David J. Stewart, MD; Jeane P. Hester, MD

Arch Neurol. 1981;38(6):369-370.

Abstract
• A patient with Philadelphia (Ph¹) chromosome-negative chronic granulocytic leukemia (CGL) had meningeal involvement three months after diagnosis. Leukemic blast cells had been noted in pleural fluid three weeks earlier. Her bone marrow remained in the benign phase. Three months of intensive therapy were required to clear the CSF of malignant cells. Myeloblastic transformation of bone marrow occurred 25 months after diagnosis, and attempts at induction of remission were unsuccessful. The CSF cytologic findings again were positive for leukemic cells the day before death, 29 months after diagnosis. Leukemic cells were found infiltrating the meninges at autopsy. This case illustrates that meningeal involvement may occur during the benign phase of Ph¹ chromosome-negative CGL. Most previously reported cases of meningeal involvement by CGL have involved patients possessing the Ph¹ chromosome, and in most cases meningeal involvement has followed malignant transformation of the bone marrow.

Author Affiliations
From the Department of Developmental Therapeutics, University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute, Houston. Dr Stewart is now with the Ontario Cancer Foundation, Ottawa, Ontario, Canada.

Footnotes
Accepted for publication Sept 15, 1980.

Reprint requests to Ontario Cancer Foundation, Ottawa General Hospital, 501 Smyth Rd, Ottawa, Ontario, Canada K1G 8L6 (Dr Stewart).