Multifocal leukoencephalopathy associated with 5-fluorouracil and levamisole adjuvant therapy for colon cancer. A report of two cases and review of the literature. The INTACC. Intergruppo Nazionale Terpia Adiuvante Colon Carcinoma.
BACKGROUND
Since 1990 the combination of 5-fluorouracil plus levamisole has been considered the standard therapy for stage B2-C resected colon cancer in the adjuvant setting. Since 1992, 14 cases of multifocal leukoencefalopathy following 5-fluorouracil and levamisole therapy have been reported.


METHODS
Two cases of this rare but severe neurological syndrome, observed at our Institution within the scope of the INTACC (Intergruppo Nazionale Terapia Adiuvante Colon Carcinoma, Italy) 01 study, are described.


CONCLUSIONS
The clinical and radiological features of the syndrome and the relationships between therapy (with the possible pivotal role played by levamisole) and onset of the multifocal leukoencephalopathy are analyzed in light of the literature data.
Luppi
G
G
Medical Oncology, University of Modena, Italy.
Zoboli
A
A
Barbieri
F
F
Crisi
G
G
Piccinini
L
L
Silingardi
V
V
D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced*; D007978:Levamisole / Q000627:therapeutic use*; D008875:Middle Aged
D007978:Levamisole; D005472:Fluorouracil