Abstract
A 7-year-old boy with chronic myelogenous leukemia complained of severe headache and vomiting twelve months after the diagnosis. A large number of atypical blastoid cells were found in the cerebrospinal fluid. The number of the blast cells in the bone marrow moderately increased, while peripheral blood examination showed characteristics of chronic phase. After intrathecal injection of anti-leukemic agents, leukemic cells in CSF disappeared and the patient became free of all his complaints. We could not define whether the transformation initially occured in the bone marrow or in the central nervous system.
Tachypnea, polydipsia and polyuria appeared eight months later, and laboratory findings suggested renal tubular acidosis (RTA). Intravenous pyelogram and ultrasonic echogram revealed enlargement of the right kidney, and renal hypofunction was shown by renogram. Three weeks after the initiation of the vincristine and prednisolone therapy, acidosis and hypokalemia were improved, and the size and function of the kidney became within normal limits. The course suggested that RTA was also due to infiltration of leukemic cells.
