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七十年代,Evans等报告中枢神经系统白血病(CNSL)的发病率不到10％,上海瑞金医院指出:急性淋巴细胞性白血病(ALL)并发CNSL达26.5％,急性粒细胞性白血病(AGL)占11.1％,急性单核细胞性白血病(AMOL)占9％。1981年Stewart等报告,ALL并发CNSL高达40～50％,最高达81％。汪氏报道50例白血病尸检资料中,颅内有浸润的达90％与生前诊断差距很大。其中蛛网膜浸润占82％,硬脑膜浸润占78.6％,脑实质浸润占62％。值得注意的是,目前临床上疑有此症的仅达0.3～58.1％。虽然近年来采用了椎管内注射氨甲喋呤(MTX)和头颅照射等预防措施,但CNSL发病率尚未减少、且已成为ALL复发和致死的主要原因之一,并直接影响白血病缓解率的提高和生存期的延长故早期诊断,预防和治疗问题,目前已成为白血病研
In the 1970s, Evans et al reported less than 10% of CNSL. Shanghai Ruijin Hospital pointed out that acute lymphoblastic leukemia (ALL) complicated with CNSL was 26.5% and acute myelogenous leukemia (AGL) accounted for 11.1%, acute monocytic leukemia (AMOL) accounted for 9%. Stewart et al. Reported in 1981 that ALL with CNSL up to 40-50% and up to 81%. Wang reported 50 cases of leukemia autopsy, intracranial infiltration of up to 90% of the difference between before and after diagnosis. Among them, arachnoid infiltration accounted for 82%, dura mater infiltration accounted for 78.6%, brain parenchyma infiltration accounted for 62%. It is noteworthy that the current clinical suspicion of this disease only reached 0.3 ~ 58.1%. Although prophylactic measures such as methotrexate (MTX) in the spinal canal and cranial irradiation have been adopted in recent years, the incidence of CNSL has not decreased and has become one of the major causes of ALL relapse and death and directly affects the improvement and survival of leukemia remission rate Prolongation of the so early diagnosis, prevention and treatment of the problem, has now become a leukemia research