Hostname: page-component-77c89778f8-vsgnj Total loading time: 0 Render date: 2024-07-16T16:10:35.102Z Has data issue: false hasContentIssue false

Complications of Chemotherapy

Published online by Cambridge University Press:  18 September 2015

J.G. Cairncross
Affiliation:
Departments of Pathology (Neuropathology), Clinincal Neurological Sciences, and Radiology, University of Western Ontario
W. Pexman*
Affiliation:
Departments of Pathology (Neuropathology), Clinincal Neurological Sciences, and Radiology, University of Western Ontario
M. Farrell*
Affiliation:
Departments of Pathology (Neuropathology), Clinincal Neurological Sciences, and Radiology, University of Western Ontario
J.J. Gilbert
Affiliation:
Departments of Pathology (Neuropathology), Clinincal Neurological Sciences, and Radiology, University of Western Ontario
J. Noseworthy
Affiliation:
Departments of Pathology (Neuropathology), Clinincal Neurological Sciences, and Radiology, University of Western Ontario
*
Pathology (Neuropathology), Victoria Hospital, London, Ontario. Canada N6A 4G5
Pathology (Neuropathology), Victoria Hospital, London, Ontario. Canada N6A 4G5
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A 2-year-old previously healthy girl presented to hospital because of irritability, fatigue, pallor and lower extremity weakness. Acute lymphoblastic leukemia (non-T non-B type) was diagnosed by peripheral blood smear and bone marrow aspirate. Chemotherapy was given and included vincristine, prednisone, L-asparaginase and intrathecal methotrexate. In addition, blood and platelet transfusions were given as appropriate. A lumbar puncture showed no cells, glucose 2.7 mmol/L (normal 2.2 – 4.4 mmol/L), protein of 0.40 (normal 0.150 – 0.450 g/L).

A routine chest x-ray had shown probable spinal column anomalies subsequently confirmed on thoraco-lumbar views as splitting of the T10 and T11 vertebra with anterior fusion. Other examiners failed to demonstrate leg weakness and at discharge (5 weeks later) the child was walking normally.

Type
Clinicopathological Conference: University of Western Ontario
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

References

1.Chernick, NL., Armstrong, D., Posner, JB: Central nervous system infections in patients with cancer. Medi 1973; 52: 563581.Google Scholar
2.Hahn, AF., Feasby, TE., Gilbert, JJ: Paraparesis following intrathecal chemotherapy. Neurol 1983; 33: 10321038.CrossRefGoogle ScholarPubMed
3.Bleyer, WA., Drake, JC., Chabner, BA: Neuro-toxicity and elevated cerebrospinal fluid methotrexate concentration in meningeal leukemia. New Eng J Med 1973; 289: 770773.CrossRefGoogle Scholar
4.Skullerud, K., Halvorsen, K: Encephalomyelopathy following intrathecal methotrexate treatment in a child with acute leukemia. Cancer 1978: 42: 12111215.3.0.CO;2-X>CrossRefGoogle Scholar
5.Ettinger, LJ: Pharmacokinetics and biochemical effects of a fatal intrathecal methotrexate overdose. Cancer 1982, 50: 444450.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
6.Clark, AW., Cohen, SR., Nissenblatt, MJ.Welson, SK: Paraplegia following intrathecal chemotherapy; neuropathological findings and elevation of myelin basic protein. Cancer 1982; 50: 4247.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
7.Williams, ME., Walker, AN.Bracikowski, JP. et al: Ascending myeloencephalopathy due to intrathecal vincristine sulfate: a fatal chemotherapeutic error. Cancer 1983: 51: 20412047.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
8.Spiegel, RJ., Cooper, PR., Blum, RH. et al: Treatment of massive intrathecal methotrexate overdose by ventriculo-lumbar perfusion. New Eng J Med 1984; 311: 386388.CrossRefGoogle Scholar
9.Poplack, DG: Massive intrathecal overdose “Check the label twice!”.CrossRefGoogle Scholar