Leukemic and lymphomatous meningitis is a major presentation of primary or secondary
central nervous system (CNS) involvement by aggressive lymphomas or acute leukemia.
Methods
The medical literature and ongoing clinical trials were reviewed on the clinical
presentation, diagnosis, prognosis, prevention, and treatment of leukemic and
lymphomatous meningitis.
Results
Treatment for secondary leukemic and lymphomatous meningitis remains unsatisfactory,
and efforts should be made to prevent and treat subclinical disease. Intrathecal and
systemic chemotherapy remain the main therapeutic approaches for this disease. Outcomes
have improved in patients with primary CNS lymphoma and meningeal involvement.
Conclusions
Appropriate selection of patients at high risk for leukemic and lymphomatous meningitis
is important so that preventive strategies can decrease the incidence of this
complication of leukemia and lymphoma. Use of chemotherapy agents that cross the
blood–brain barrier and the adoption of high-dose chemotherapy with autologous
hematopoietic stem cell transplantation have increased the proportion of patients whose
primary disease is cured.
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