title: High dose Ara-C related leukoencephalopathy.
abstract: Two patients with acute myelomonocytic leukemia in central nervous system relapse developed clinical signs and computerized tomographic evidence of leukoencephalopathy five to seven days after intravenous high dose Ara-C therapy. The first patient had received 30 gm of intravenous Ara-C with cranial irradiation (1680 rad in 2 fractions) and intrathecal Ara-C (100 mg X twice) for an intracerebral chloroma and leptomeningeal leukemia. In this patient the leukoencephatlopathy was probably a result of a synergistic effect of the concomitant triple therapy. The second patient had received intrathecal administration of Ara-C and methotrexate for five and one-half months prior to intravenous Ara-C therapy. He developed altered mental status after 24 gm of intravenous Ara-C infusion. CT scan showed changes in the white matter compatible with leukoencephalopathy. In this patient the intravenous Ara-C probably was the precipitating factor of the development of leukoencephalopathy. The possible mechanism of the Ara-C induced leukoencephalopathy is discussed.
authors.forename: T L
authors.initials: TL
authors.lastname: Hwang
authors.forename: W K
authors.initials: WK
authors.lastname: Yung
authors.forename: Y Y
authors.initials: YY
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Borit
authors.forename: W S
authors.initials: WS
authors.lastname: Fields
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects / Q000473:pathology; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D003561:Cytarabine