Advertisement
Research Article| Volume 16, ISSUE 3, P246-248, May 1994

Download started.

Ok

Acute ascending myelitis and encephalopathy after intrathecal cytosine arabinoside and methotrexate in an adolescent boy with acute lymphoblastic leukemia

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      A 14-year-old boy with acute lymphoblastic leukemia developed acute ascending myelitis followed by encephalopathy after intrathecal administration of methotrexate 15 mg and cytosine arabinoside 50 mg. The patient had none of the risk factors noted previously in other patients with intrathecal therapy (IT) induced neurotoxicity. The doses administered were within the standard scales, and toxicity developed in the second boost of IT 20 days after the first one. There may not be any parameters to predict the occurrence of such severe and rare form of CNS neurotoxicity attributed to IT.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Reference

        • Bleyer WA
        • Poplack DA
        Prophylaxis and treatment of leukemia in the central nervous system and other sanctuaries.
        Sem Oncol. 1985; 12: 131-148
        • Ochs JJ
        Neurotoxicity due to central nervous system therapy for childhood leukemia.
        Am J Pediatr Hematol Oncol. 1989; 11: 93-105
        • Nelson RW
        • Frank JT
        Intrathecal methotrexate-induced neurotoxicities.
        Am J Hosp Pharm. 1981; 38: 65-68
        • Shibutani M
        • Okeda R
        • Hori A
        • Schipper H
        Methotrexate-related multifocal axonopathy.
        Acta Neuropathol. 1989; 79: 333-335
        • Yim YS
        • Mahoney DH
        • Oshman DG
        Hemiparesis and ischemic changes of the white matter after intrathecal therapy for children with acute lymphocytic leukemia.
        Cancer. 1991; 67: 2058-2061
        • Phantumchinda K
        • Intragumtornchai T
        • Kasantikul V
        Stroke-like syndrome, mineralizing microangiopathy, and neuroaxonal dystrophy following intrathecal methotrexate therapy.
        Neurology. 1991; 41: 1847-1848
        • Kay HEM
        • Knapton PJ
        • O'Sullivan JP
        • et al.
        Encephalopathy in acute leukaemia associated with methotrexate therapy.
        Arch Dis Child. 1972; 47: 344-354
        • Borgeat A
        • De Muralt B
        • Stalder M
        Peripheral neuropathy associated with high-dose Ara-C therapy.
        Cancer. 1986; 58: 852-854
        • Resar LMS
        • Phillips PC
        • Kastan MB
        • Leventhal BG
        • Bowman PW
        • Civin CI
        Acute neurotoxicity after intrathecal cytosine arabinoside in two adolescents with acute lymphoblastic leukemia of B-cell type.
        Cancer. 1993; 71: 117-123
        • Raney B
        • Tefft M
        • Heyn R
        • et al.
        Ascending myelitis after intensive chemotherapy and radiation therapy in children with intracranial parameningeal sarcoma.
        Cancer. 1992; 69: 1498-1506
        • Werner RA
        Paraplegia and quadriplegia after intrathecal chemotherapy.
        Arch Phys Med Rehabil. 1988; 69: 1054-1056
        • Crawford SM
        • Rustin GJS
        • Bagshawe KD
        Acute neurological toxicity of intrathecal cytosine arabinoside: a case report.
        Cancer Chemother Pharmacol. 1986; 16: 306-307
        • Bleyer WA
        • Drake JC
        • Chabner BA
        Neurotoxicity and elevated cerebrospinal fluid methotrexate concentration in meningeal leukemia.
        N Engl J Med. 1973; 289: 770-773