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Parenchymal brain leukemia. Case report: problems related to the diagnosis and treatment.

Abstract
A case of intracerebral nodular leukemic mass that developed in a girl eight years after a diagnosis of acute lymphoblastic leukemia (ALL) and 18 months after second discontinuation of therapy for a central nervous system (CNS) relapse is reported. The morphologic picture and the long time that elapsed from the diagnosis raised the suspicion of a cerebral neoplasm; the immediate and dramatic effect of steroid treatment, on the contrary, indicated the presence of a leukemic infiltration and in the meantime, a bone marrow relapse occurred. The patient soon after received high-dose Cytosine Arabinoside (HD ARA C) + Vincristine (VCR) + Levo-Asparaginase (L-ASE) + Prednisone (PDN) without any intrathecal antiblastic drug. We observed a neurological recovery and a complete disappearance of the mass. After consolidation of the remission the patient began an ablative regimen for bone marrow transplantation. The efficacy of HD ARA C in the treatment of the intracerebral nodular leukemic mass is emphasized.
AuthorsA Corbetta, M Jankovic, V Conter, T Fuga, M Crivellaro, G Masera
JournalHaematologica (Haematologica) 1991 Jul-Aug Vol. 76 Issue 4 Pg. 324-6 ISSN: 0390-6078 [Print] Italy
PMID1794739 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cytarabine
  • Vincristine
  • Dexamethasone
  • Asparaginase
  • Prednisone
  • Methotrexate
Topics
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Aphasia (etiology)
  • Asparaginase (administration & dosage)
  • Blood-Brain Barrier
  • Bone Marrow Transplantation
  • Brain Neoplasms (complications, diagnosis, drug therapy, epidemiology, prevention & control)
  • Child, Preschool
  • Combined Modality Therapy
  • Cranial Irradiation
  • Cytarabine (administration & dosage, pharmacokinetics)
  • Dexamethasone (administration & dosage)
  • Female
  • Humans
  • Intracranial Pressure
  • Methotrexate (administration & dosage)
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (pathology, therapy)
  • Prednisone (administration & dosage)
  • Remission Induction
  • Vincristine (administration & dosage)

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