Progressive vacuolar myelopathy and leukoencephalopathy in childhood acute lymphoblastic leukemia and transient improvement with vitamin B12.
Vacuolar myelopathy (VM) in leukemia is rare. We report a boy with leukemia who developed isolated central nervous system (CNS) relapse during reinduction therapy. 5 months after cranial radiotherapy, he gradually developed quadriparesis. Magnetic resonance imaging revealed an intramedullary lesion which extended through the cervical spine. Serum vitamin B12, folic acid, cerebrospinal fluid methyl malonic acid were normal. Viral screening by ELISA was negative. He had lymphopenia, and reduced immunoglobulins, from a cardiac arrest. Biopsy revealed VM. He responded to weekly vitamin B12 treatment but on the 6th week of the therapy he died after developing periventricular, gliotic, hyperintense lesions in the brain.
Olcay
Lale
L
Unit of Pediatric Hematology, Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Demetevler, Ankara, Türkiye.
Irkkan
Ciğdem
C
Senbil
Nesrin
N
Uzun
Haci
H
Basmaci
Mehmet
M
Gürer
Y K Yavuz
YK
D016543:Central Nervous System Neoplasms; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D012008:Recurrence; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000188:drug therapy; D014805:Vitamin B 12 / Q000627:therapeutic use*
D014805:Vitamin B 12