title: Brain white matter changes during treatment of a child for acute lymphoblastic leukemia.
abstract: A 13-year old boy with acute lymphoblastic leukemia had bilateral paresis of the upper extremities and aphasia 1 week after high dose methotrexate and triple intrathecal therapy (methotrexate, cytarabin, hydrocortisone). The stroke-like neurological symptoms disappeared on the third day. T2-weighted magnetic resonance imaging showed hyperintensities of white matter on the second day. Despite resolution of the neurological symptoms, magnetic resonance images were still abnormal 3 years after the attack. Methotrexate has been considered to be responsible for ischemic damage to oligodendroglial cells, resulting in demyelination. The changes are occasionally prolonged without persistent neurologic symptoms.
authors.affiliation: Department of Pediatrics, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. maeda@nms.ac.jp
authors.forename: Miho
authors.initials: M
authors.lastname: Maeda
authors.forename: Jun
authors.initials: J
authors.lastname: Hayakawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ueda
authors.forename: Makoto
authors.initials: M
authors.lastname: Migita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Asano
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fukunaga
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Amano
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001921:Brain / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate