Central nervous system complications of leukemic conversion of the lymphomas

Forty‐seven cases of lymphosarcoma and reticulum cell sarcoma in which leukemic conversion occurred were compared to 48 cases of lymphosaicoma in which leukemic conversion did not occur. The mortality, morbidity, and neurologic complications were studied. The mortality was greatest in the leukemic group regardless of the presence of neurologic complications. Forty percent of the leukemic group developed neurologic complications in contrast to 23 percent of the nonleukemic group. Forty‐four percent of the neurologic complications in the leukemic group were meningeal sarcomatosis. The infiltrative meningitis was “atypical” in its presentation in view of the relatively small number of premonitory signs and symptoms. In the nonleukemic group, there were 44.4 percent peripheral neurologic problems and no meningeal complications. The meningeal syndrome responded to a number of therapeutic regimens, the most widely used in this study being intrathecal methotrexate. It is concluded that the rapid course of illness in the leukemic group and the neurologic complications (similar to those encountered in acute leukemia) reflect the severity of illness and acuteness of the leukemia.