Antineoplastics
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Reactions 1356 - 18 Jun 2011 the seizure, an MRI showed altered signals and RPLS was diagnosed after exclusion of other causes. His speech ★ S Antineoplastics normalised over the next 2 days, and his mental status returned to baseline. One month after the event, a repeat Reversible posterior leukoencephalopathy MRI was completely normal; seizures had not recurred syndrome (first report with pegaspargase) in 4 months after the RPLS episode, and he had no paediatric patients: 4 case reports neurological deficits. Four paediatric patients, three boys and one girl, developed reversible posterior leukoencephalopathy Baytan B, et al. Reversible posterior leukoencephalopathy induced by cancer chemotherapy. [Review]. Pediatric Neurology 43: 197-201, No. 3, Sep 2010 - syndrome (RPLS) during chemotherapy [not all dosages and Turkey 803055802 routes stated]. A 12-year-old boy with acute lymphoblastic leukaemia » Editorial comment: A search of AdisBase, Medline and (ALL) achieved bone marrow remission after induction Embase did not reveal any previous case reports of therapy and then started receiving high-risk block reversible posterior leukoencephalopathy syndrome chemotherapy. On day 2 of this regimen, after receiving IV associated with pegaspargase. The WHO ADR database methotrexate 5 g/m 2 /24h, vincristine 1.5 mg/m 2 /dose, oral contained five reports of posterior reversible encephalopathy dexamethasone 20 mg/m 2 /day and intrathecal syndrome associated with pegaspargase. methotrexate-cytarabine-prednisone, mental status changes were observed and he developed blindness. His BP increased to 140/90–155/95mm Hg and he experienced two generalised tonic-clonic seizures a few hours later; each seizure lasted for approximately 5 minutes. Chemotherapy was discontinued, and he started receiving phenytoin, nifedipine and antibacterials. Approximately 3 hours after the incident, MRI findings were suggestive of vasogenic oedema, and RPLS was suspected. His blindness gradually resolved within 12 hours, and delirium and visual hallucinations recovered after 36 hours. Chemotherapy was resumed after 20 days, and a repeat MRI was normal 35 days later. RPLS did not recur during the subsequent 36 months. A 14-year-old girl with ALL treated according to an ALL protocol received her last dose of pegaspargase 1000 U/m 2 , and developed headache, weakness and two consecutive focal seizures with loss of consciousness 3 hours later. She began receiving phenytoin and regained consciousness after approximately 4 hours. Bilateral Babinski signs were positive, her BP was 150/100mm Hg, and MRI findings were consistent with vasogenic oedema. Most of her symptoms resolved within 12 hours, but delirium and hallucinations persisted for 30 hours. Chemotherapy was resumed 10 days after RPLS, and a repeat MRI showed complete resolution of RPLS changes 4 days later. RPLS had not recurred 5 months later. An 11-year-old boy with ALL completed induction therapy and was then treated according to a high risk arm protocol. On the second day of high risk block therapy, 5 hours after initiation of a methotrexate 5 g/m 2 /24h infusion and administration of intrathecal methotrexate- cytarabine-prednisone, he experienced two generalised tonic-clonic seizures. The seizures were preceded by headache and lasted for 3–5 minutes. His BP initially fluctuated between 160 and 178mm Hg (systolic), and 70 and 98mm Hg (diastolic). Neurological examination showed somnolence, disorientation, flattened affect and decreased interaction. Treatment comprised nifedipine, phenytoin and supportive therapy. No seizure activity was evident on EEG. Following a cranial MRI, RPLS was diagnosed. His condition improved within the next 10 hours, and MRI findings had normalised 4 weeks later. No neurological deficits were noticed during 30 months of follow-up. A 12-year-old boy with non-Hodgkin lymphoma started receiving high risk block therapy. After administration of dexamethasone 20 mg/m 2 /day, methotrexate 5 g/m 2 , vincristine 1.5 mg/m 2 and intrathecal methotrexate- cytarabine-prednisone on day 2, he developed speech difficulty, headache, sopor and two generalised seizures. Seizures were terminated with midazolam and phenytoin. His BP ranged from 140/100 to 170/110mm Hg, and antihypertensive therapy was initiated. Three hours after 1 Reactions 18 Jun 2011 No. 1356 0114-9954/10/1356-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1356 - 18 Jun 2011
the seizure, an MRI showed altered signals and RPLS wasdiagnosed after exclusion of other causes. His speech★ SAntineoplasticsnormalised over the next 2 days, and his mental statusreturned to baseline. One month after the event, a repeatReversible posterior leukoencephalopathyMRI was completely normal; seizures had not recurredsyndrome (first report with pegaspargase) in4 months after the RPLS episode, and he had nopaediatric patients: 4 case reportsneurological deficits.Four paediatric patients, three boys and one girl,
developed reversible posterior leukoencephalopathy Baytan B, et al. Reversible posterior leukoencephalopathy induced by cancerchemotherapy. [Review]. Pediatric Neurology 43: 197-201, No. 3, Sep 2010 -syndrome (RPLS) during chemotherapy [not all dosages andTurkey 803055802routes stated].
A 12-year-old boy with acute lymphoblastic leukaemia » Editorial comment: A search of AdisBase, Medline and(ALL) achieved bone marrow remission after induction Embase did not reveal any previous case reports oftherapy and then started receiving high-risk block reversible posterior leukoencephalopathy syndromechemotherapy. On day 2 of this regimen, after receiving IV associated with pegaspargase. The WHO ADR databasemethotrexate 5 g/m2/24h, vincristine 1.5 mg/m2/dose, oral contained five reports of posterior reversible encephalopathydexamethasone 20 mg/m2/day and intrathecal syndrome associated with pegaspargase.methotrexate-cytarabine-prednisone, mental statuschanges were observed and he developed blindness. HisBP increased to 140/90–155/95mm Hg and he experiencedtwo generalised tonic-clonic seizures a few hours later;each seizure lasted for approximately 5 minutes.Chemotherapy was discontinued, and he started receivingphenytoin, nifedipine and antibacterials. Approximately3 hours after the incident, MRI findings were suggestive ofvasogenic oedema, and RPLS was suspected. His blindnessgradually resolved within 12 hours, and delirium and visualhallucinations recovered after 36 hours. Chemotherapywas resumed after 20 days, and a repeat MRI was normal35 days later. RPLS did not recur during the subsequent36 months.
A 14-year-old girl with ALL treated according to an ALLprotocol received her last dose of pegaspargase 1000 U/m2,and developed headache, weakness and two consecutivefocal seizures with loss of consciousness 3 hours later. Shebegan receiving phenytoin and regained consciousnessafter approximately 4 hours. Bilateral Babinski signs werepositive, her BP was 150/100mm Hg, and MRI findingswere consistent with vasogenic oedema. Most of hersymptoms resolved within 12 hours, but delirium andhallucinations persisted for 30 hours. Chemotherapy wasresumed 10 days after RPLS, and a repeat MRI showedcomplete resolution of RPLS changes 4 days later. RPLS hadnot recurred 5 months later.
An 11-year-old boy with ALL completed inductiontherapy and was then treated according to a high risk armprotocol. On the second day of high risk block therapy,5 hours after initiation of a methotrexate 5 g/m2/24hinfusion and administration of intrathecal methotrexate-cytarabine-prednisone, he experienced two generalisedtonic-clonic seizures. The seizures were preceded byheadache and lasted for 3–5 minutes. His BP initiallyfluctuated between 160 and 178mm Hg (systolic), and70 and 98mm Hg (diastolic). Neurological examinationshowed somnolence, disorientation, flattened affect anddecreased interaction. Treatment comprised nifedipine,phenytoin and supportive therapy. No seizure activity wasevident on EEG. Following a cranial MRI, RPLS wasdiagnosed. His condition improved within the next10 hours, and MRI findings had normalised 4 weeks later.No neurological deficits were noticed during 30 months offollow-up.
A 12-year-old boy with non-Hodgkin lymphoma startedreceiving high risk block therapy. After administration ofdexamethasone 20 mg/m2/day, methotrexate 5 g/m2,vincristine 1.5 mg/m2 and intrathecal methotrexate-cytarabine-prednisone on day 2, he developed speechdifficulty, headache, sopor and two generalised seizures.Seizures were terminated with midazolam and phenytoin.His BP ranged from 140/100 to 170/110mm Hg, andantihypertensive therapy was initiated. Three hours after
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Reactions 18 Jun 2011 No. 13560114-9954/10/1356-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
