Intracranial leukaemia and the cerebrospinal fluid.

With the prolongation of survival in patients with acute leukaemia the incidence of central nervous system involvement has shown a coincidental increase (Evans et al., 1970). Its actual frequency, however, remains difficult to estimate, for symptoms and signs may be minimal and meningeal leukaemia often occurs during bone marrow remission. Reports on patients with acute leukaemia and signs of raised intracranial pressure in whom examination of the cerebrospinal fluid has shown no increase in white cell count are few. The cases of two patients with acute myeloblastic leukaemia, both of whom were in relapse and had signs of raised intracranial pressure without cells in the cerebrospinal fluid, are described here. Both responded to therapy with systemic and intrathecal cytotoxic agents.