{'fraction_non_alphanumeric': 0.032046332046332046, 'fraction_numerical': 0.03397683397683398, 'mean_word_length': 5.096470588235294, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
COMPLETE REMISSION OF PARAPROTEINAEMIA AND NEUROPATHY FOLLOWING IATROGENIC ORAL MELPHALAN OVERDOSE

were irradiated to a dose of 30.6 Gy in 17 fractions (1.8 Gy per fraction) over a period of 4 weeks using a linear accelerator (8 MV). Because of severe sepsis (coagulasenegative staphylococci and enterobacter cloacae) and pancytopenia (leucocytes 9.0 x 108/1, red blood cells 1.58 x 1012/1, thrombocytes 7-3 x 101o/l) 10 d after the end of radiotherapy the patient had to be treated with antibiotics (ceftazidim, vancomycin, tobramycin) and 5 irradiated blood units as well as GM-CSF 150 pg subcutaneously twice daily and oral dexamethason 6 mg once per day for a period of 5 d. Five days alter onset of this treatment pancytopenia improved mildly (leucocytes 1.7 x 109/l. red blood cells 2.0 x 1012/1 and thrombocytes 12.7 x 1O1O/1). GM-CSF treatment was continued for another 10 d. The risk of therapy-related complications including bone marrow suppression was considered high in that phase of the disease and cranial CT and clinical examination revealed complete remission of the meningeal tumour. Therefore, no antineoplastic chemotherapy and boost irradiation to the tumour site were given and followups were performed at 3-month intervals. Nineteen months after diagnosis the patient is free of meningeal, cerebral or spinal involvement of the lymphoma (negative neurological status, cranial MR. CSF chemistry and cytocentrifuge preparation). Blood laboratory shows a mild pancytopenia (leucocytes 3 x 10y//l, haemoglobin 11.7 g/dl, red blood cells 3.83 x 10’2/1, thrombocytes 1.36 x 10”/1), normal differential blood cell counts and no lymphatic or extralymphatic organ manifestation of the disease. Dementia as the primary clinical manifestation of a small lyrnphocytic lymphoma (immunocytorna) infiltrating the meninges is exceptional (Brittinger et al, 1984). The complete neurological remission 18 months after radiotherapy without subsequent chemotherapy is surprising (Recht et al, 1988; for review). The course of the disease in our patient suggests that after neuraxial irradiation of meningeal small lymphocytic lymphoma intrathecal or systemic antineoplastic chemotherapy can probably be withheld and, thus, cumulative toxicity minimized as long as regular neurological and neuroradiological examinations and CSF analyses present no evidence of a neuraxial relapse of the disease. In the light of the repopulation of the bone marrow by the neoplastic clone after radiotherapy (60% infiltration) it is surprising that the disease did not recur in the CNS and the meninges.