Severe and irreversible myelopathy after concurrent systemic and intrathecal nucleoside analogue treatment for refractory diffuse large B-cell lymphoma: A case report and review of the literature.
J Oncol Pharm Pract
; 22(3): 523-7, 2016 Jun.
Article
en En
| MEDLINE
| ID: mdl-25655468
ABSTRACT
We report a patient with refractory diffuse large B-cell lymphoma who developed irreversible, severe spinal neurotoxicity after concurrent treatment with intrathecal and systemic cytarabine. Shortly after concomitant administration of intrathecal triple therapy (MTX, dexamethasone and cytarabine) and high-dose systemic cytarabin (R-DHAP protocol) the patient lost control of bowel and bladder function and developed an ascending, irreversible paraplegia. Infectious or neoplastic diseases of the spinal cord were ruled out. A magnetic resonance imaging scan of the spine resulted in a diagnosis of toxic myelitis. Previously observed cases of spinal neurotoxicity after cytarabine treatment are reviewed as well as current guidelines for the use of intrathecal chemotherapy in high-grade non-Hodgkin lymphoma. In summary, severe spinal neurotoxicity of intrathecal chemotherapy is a rare side-effect, however several studies suggest that the neurotoxicity of cytarabine is significantly enhanced by concurrent intrathecal and high-dose systemic administration. Simultaneous high-dose systemic and intrathecal chemotherapy with cytarabine should therefore be avoided.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades de la Médula Espinal
/
Índice de Severidad de la Enfermedad
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Linfoma de Células B Grandes Difuso
Tipo de estudio:
Guideline
Límite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
J Oncol Pharm Pract
Asunto de la revista:
FARMACIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Alemania