A Case of Chronic Myelogenous Leukemia in Blastic Crisis and Acute Paraplegia. A Case Report and a Review of the Literature

摘要

A 44-year-old man was admitted to hospital because of splenomegaly. Diagnosis of Ph^1-positive chronic mylogenous leukemia (CML) was made on the hematological examination. During three years, he did fairly well with administration of busulfan. On Feb. 15. 1980, he complained of low back pain and suddenly developed paraplegia. The myelography demonstrated a complete obstraction of contrast materials, which suggested an extradural mass formation from the 8 th thracic to the 2nd lumbar vertebrae. With local radiotherapy, low back pain was slightly improved, but neurological signs remained unchanged. One and a half months later, he had a blastic crisis with a rapidly rising white cell count. In spite of systemic chemotherapy, he died about two and a half months after the development of paraplegia. Pathological diagnosis in autopsy was CML with tumor formation of the epidural space. Fifty-six cases of spinal leukemia reported in Japanese literature during the years 1965 through 1982 were reviwed, and discussed in relation with the present case reported.