Progressive paresthesia and weakness after intrathecal chemotherapy.
A 53-year-old woman was diagnosed with acute lymphoblastic leukemia (ALL) confirmed by bone marrow biopsy to be pre-B ALL. The patient underwent a hyperfractionated cyclophosphamide, doxorubicin, vincristine, and dexamethosone (hyper-CVAD) regimen, except the doxorubicin was withheld. She received two intrathecal injections of cytarabine and methotrexate and two months later presented to Tulane University Hospital with paresthesias and weakness causing her to be wheelchair bound.
Marshall
Richard
R
Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
Gupta
Neel D
ND
Palacios
Enrique
E
Neitzschman
Harold R
HR
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology*; D010292:Paresthesia / Q000175:diagnosis / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D052879:Subacute Combined Degeneration / Q000139:chemically induced* / Q000175:diagnosis; D013904:Thoracic Vertebrae; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide