Antineoplastics
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Reactions 1088 - 11 Feb 2006 S Antineoplastics Fatal posterior leukoencephalopathy: case report A 36-year-old woman developed posterior leukoencephalopathy during antineoplastic therapy for non- Hodgkin’s lymphoma. The woman initially received dexamethasone 40 mg/day for 4 days, a continuous infusion of cisplatin 100 mg/m 2 for 24 hours on day 1 and cytarabine 2 g/m 2 every 12 hours on day 2. Disease progression was noted after the second cycle. Forty days later, she experienced a tonic-clonic seizure and received primidone. An MRI scan was suggestive of leptomeningeal involvement and she received intrathecal methotrexate [dosage and duration of treatment not stated]. However, subsequent cerebrospinal fluid analysis showed no evidence of lymphoma. Following disease progression, she received ifosfamide 1000 mg/m 2 and mesna 600 mg/m 2 for 5 days, etoposide 150 mg/m 2 on days 1–5 and idarubicin 10mg/m 2 on days 1–2. On day 1, her BP began to increase and, on day 3, antineoplastic therapy was discontinued because of elevated serum creatinine and uric acid levels. On day 4, she developed refractory seizures in addition to episodes of disorientation and possible hallucinations. On examination, she was stuporous and had cortical blindness and optic disc swelling. An MRI scan showed heterogeneous, bilateral, non- enhancing lesions in the brainstem, cerebellum and posterior occipital, temporal and parietal regions, suggestive of posterior leukoencephalopathy. Despite haemodialysis and supportive care, the woman’s symptoms continued to worsen and she subsequently died. Author comment: "Although there appears to be a link between these drugs and [posterior leukoencephalopathy] in the setting of T cell lymphoma, it is difficult to establish exactly which drug or combination of drugs is responsible." Abali H, et al. Posterior leukoencephalopathy after combination chemotherapy in a patient with lymphoma. Leukemia and Lymphoma 46: 1825-1828, No. 12, Dec 2005 - Turkey 801030453 1 Reactions 11 Feb 2006 No. 1088 0114-9954/10/1088-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1088 - 11 Feb 2006
SAntineoplastics
Fatal posterior leukoencephalopathy: case reportA 36-year-old woman developed posterior
leukoencephalopathy during antineoplastic therapy for non-Hodgkin’s lymphoma.
The woman initially received dexamethasone 40 mg/day for4 days, a continuous infusion of cisplatin 100 mg/m2 for24 hours on day 1 and cytarabine 2 g/m2 every 12 hours onday 2. Disease progression was noted after the second cycle.Forty days later, she experienced a tonic-clonic seizure andreceived primidone. An MRI scan was suggestive ofleptomeningeal involvement and she received intrathecalmethotrexate [dosage and duration of treatment not stated].However, subsequent cerebrospinal fluid analysis showed noevidence of lymphoma. Following disease progression, shereceived ifosfamide 1000 mg/m2 and mesna 600 mg/m2 for5 days, etoposide 150 mg/m2 on days 1–5 and idarubicin10mg/m2 on days 1–2. On day 1, her BP began to increase and,on day 3, antineoplastic therapy was discontinued because ofelevated serum creatinine and uric acid levels. On day 4, shedeveloped refractory seizures in addition to episodes ofdisorientation and possible hallucinations. On examination,she was stuporous and had cortical blindness and optic discswelling. An MRI scan showed heterogeneous, bilateral, non-enhancing lesions in the brainstem, cerebellum and posterioroccipital, temporal and parietal regions, suggestive ofposterior leukoencephalopathy.
Despite haemodialysis and supportive care, the woman’ssymptoms continued to worsen and she subsequently died.
Author comment: "Although there appears to be a linkbetween these drugs and [posterior leukoencephalopathy] inthe setting of T cell lymphoma, it is difficult to establishexactly which drug or combination of drugs is responsible."Abali H, et al. Posterior leukoencephalopathy after combination chemotherapy in apatient with lymphoma. Leukemia and Lymphoma 46: 1825-1828, No. 12, Dec2005 - Turkey 801030453
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Reactions 11 Feb 2006 No. 10880114-9954/10/1088-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
