Treatment Sequencing in a Chronic Lymphocytic Leukemia Patient with Central Nervous System Involvement
2018
Early-stage
chronic lymphocytic leukemia(CLL) with neurologic involvement is a rare condition and should require a careful follow-up. Although no standard protocol exists for this condition,
intrathecal chemotherapy, combined with systemic
chemoimmunotherapy, has been used previously. This case describes the treatment of a patient with CLL and symptomatic compromise of the central nervous system. Our results suggest that a combination of chemotherapy, radiotherapy, and
ibrutinib, administered sequentially over a 2-year period, led to a near-complete resolution of the
cerebral spinal fluidneoplastic infiltration. Importantly, this response has been maintained with
ibrutinibmonotherapy for more than 12 months.
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