Transient cerebral dysfunction following chemotherapy for osteogenic sarcoma.
An unusual neurological syndrome occurred in 4  of 158 patients treated for osteogenic sarcoma with combination chemotherapy. There was an abrupt onset of focal cerebral deficits approximately ten days after chemotherapy with vincristine and high-dose methotrexate plus citrovorum factor rescue. The syndrome was short lived and always occurred early in the course of treatment. Prolonged neurological deficits remained in 2 patients. When similar chemotherapy was reinstituted in the 4 patients, no further neurological complications ensued. Possible causes include a leukoencephalopathy related to methotrexate or an embolic cerebral vasculopathy related to necrotic tumor microemboli emanating from the lungs.
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000188:drug therapy*; D001927:Brain Diseases / Q000139:chemically induced / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D005266:Femoral Neoplasms / Q000188:drug therapy; D006801:Humans; D006811:Humerus; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009362:Neoplasm Metastasis; D012516:Osteosarcoma / Q000188:drug therapy*; D010384:Pelvic Bones; D013577:Syndrome; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D002955:Leucovorin; D008727:Methotrexate