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进行性多灶性白质脑病(PML)是中枢神经系统脱髓鞘疾病,临床罕见,作者现报告伴发于慢性淋巴细胞白血病一例。患者男,61岁。1977年10月发现无痛性多组淋巴结肿大。经外周血及骨髓检查,诊断为慢性淋巴细胞白血病(CLL)。间歇用苯丁酸氮芥、强的松治疗7.5年余。开始阶段临床和血液学反应良好,1985年6月后病情恶化。白细胞50×10~9/L,Hb123g/L,血小板134×10~9/L。骨髓增生极度活跃,淋巴88%。开始用COP方案(环磷酰胺、长春新碱和强的松)治疗,每月1次。第二疗程后,出现缓慢进行性右侧肢体无力,定向力、智能障碍、注意力不集中,表情淡漠,侧
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system and is clinically rare. The authors now report a case of chronic lymphocytic leukemia. Male patient, 61 years old. In 1977 October found that painless multi-group swollen lymph nodes. Peripheral blood and bone marrow examination, the diagnosis of chronic lymphocytic leukemia (CLL). Intermittent chlorambucil, prednisone treatment more than 7.5 years. The initial clinical and hematological response was good, and the condition deteriorated after June 1985. White blood cells 50 × 10 ~ 9 / L, Hb123g / L, platelet 134 × 10 ~ 9 / L. Myeloid hyperplasia is extremely active, lymphatic 88%. Start treatment with COP regimen (cyclophosphamide, vincristine and prednisone) once per month. After the second course of treatment, there was a slow progressive right limb weakness, disorientation, mental retardation, inattention, indifferent expression, side