[Common acute lymphoblastic leukemia showing hypo-gamma-globulinemia and cerebral infarction due to cerebral artery obstruction].

A patient who developed hypo-gamma-globulinemia and cerebral infarction during the treatment for acute lymphoblastic leukemia (ALL) is reported. In this patient fever and rash during radio-therapy for central nervous system (CNS) prophylaxis and nausea and vomiting were observed during maintenance therapy. On the laboratory findings high level of the protein level in the cerebrospinal fluid and the eosinophil count of the peripheral blood were found in every examination. We attempted to isolate various viruses in consideration of the possibility of infection, but no virus could be detected. The effects of methotrexate (MTX) and l-asparaginase were also suspected. Since nausea and vomiting disappeared after discontinuation of MTX administration, the drug may had some effect, and the possibility of cerebral damage by MTX can not be excluded. Complication of irradiation are reported to occur often more than 10 years after the treatment, but this patient had the onset only 2 years after the treatment. Therefore, irradiation was unlikely to be responsible for the symptoms. The relation between the hypo-gamma-globulinemia and cerebral infarction was also unknown.