Acute fatal myeloencephalopathy after combined intrathecal chemotherapy in a child with acute lymphoblastic leukemia

N X von der Weid; H de Crousaz; D Beck; T Deonna; J Miklossy; R C Janzer

doi:10.1002/mpo.2950190309

Acute fatal myeloencephalopathy after combined intrathecal chemotherapy in a child with acute lymphoblastic leukemia

Med Pediatr Oncol. 1991;19(3):192-8. doi: 10.1002/mpo.2950190309.

Authors

N X von der Weid¹, H de Crousaz, D Beck, T Deonna, J Miklossy, R C Janzer

Affiliation

¹ Pediatric Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

PMID: 2023567
DOI: 10.1002/mpo.2950190309

Abstract

We report a case of a fatal toxic encephalomyelopathy in a 12-year-old girl due to prophylactic intrathecal injection of methotrexate and cytosine arabinoside, with a characteristic progressive symptomatology leading to death after 28 days. The location and type of neuropathological changes support the hypothesis of a direct toxic effect of methotrexate and/or cytosine arabinoside on structures directly exposed to the cerebrospinal fluid.

Publication types

Case Reports
Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / adverse effects*
Brain Diseases / chemically induced*
Brain Diseases / pathology
Child
Coma / chemically induced
Cytarabine / administration & dosage
Cytarabine / adverse effects
Female
Humans
Injections, Spinal
Methotrexate / administration & dosage
Methotrexate / adverse effects
Neoplasm Recurrence, Local
Paralysis / chemically induced
Paraplegia / chemically induced
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Spinal Cord Diseases / chemically induced*
Spinal Cord Diseases / pathology

Substances

Cytarabine
Methotrexate