title: Peripheral neuropathy caused by high-dose cytosine arabinoside treatment in a patient with acute myeloid leukemia.
abstract: The central nervous system toxicity of high-dose cytosine arabinoside is well recognized, but the toxicity of cytosine arabinoside in the peripheral nervous system has been infrequently reported. A 49-year-old Japanese man was diagnosed with acute myeloid leukemia. After he achieved complete remission, he received high-dose cytosine arabinoside treatment (2 g/m2 twice a day for 5 days; total, 20 g/m2) as consolidation therapy. The first course of high-dose cytosine arabinoside resulted in no unusual symptoms, but on day 21 of the second course of treatment, the patient complained of numbness in his right foot. Electromyogram and nerve-conduction studies showed peripheral neuropathy in both peroneal nerves. This neuropathy was gradually resolving; however, after the patient received allogeneic bone marrow transplantation, the symptoms worsened, with the development of graft-versus-host disease, and the symptoms subsequently responded to methylprednisolone. Although the mechanisms of peripheral neuropathy are still unclear, high-dose cytosine arabinoside is a therapy that is potentially toxic to the peripheral nervous system, and auto/alloimmunity may play an important role in these mechanisms.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Jikei University School of Medicine, 19-18 Nishishinbashi 3-chome, Minato-ku, Tokyo, 105-8461, Japan. takexsaito@aol.com
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.forename: Osamu
authors.initials: O
authors.lastname: Asai
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Dobashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Yano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Osawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takei
authors.forename: Shinobu
authors.initials: S
authors.lastname: Takahara
authors.forename: Yoji
authors.initials: Y
authors.lastname: Ogasawara
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Jiro
authors.initials: J
authors.lastname: Minami
authors.forename: Noriko
authors.initials: N
authors.lastname: Usui
mesh_terms: D000208:Acute Disease; D003561:Cytarabine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*
chemical_list: D003561:Cytarabine