title: Fatal neurotoxicity in a patient with down syndrome treated with chemotherapy, irradiation, stem cell transplant, and clofarabine.
abstract: Clofarabine is an effective therapy of pediatric patients with relapsed acute lymphoblastic leukemia (ALL). We present a child with Down syndrome who had received previous chemotherapy, cranial radiation, and a stem cell transplant with total body irradiation for her acute lymphoblastic leukemia. She subsequently relapsed and was treated with clofarabine. After her third course, she had a stroke that was felt to be secondary to dehydration and radiation vasculitis. After her subsequent course of clofarabine, she developed fatal neurotoxicity.
authors.affiliation: Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H8L1, Canada. djohnston@cheo.on.ca
authors.forename: Donna L
authors.initials: DL
authors.lastname: Johnston
authors.forename: Tejinder
authors.initials: T
authors.lastname: Bains
authors.forename: Karen
authors.initials: K
authors.lastname: Mandel
authors.forename: Robert
authors.initials: R
authors.lastname: Klaassen
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Halton
mesh_terms: D000227:Adenine Nucleotides / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001087:Arabinonucleosides / Q000009:adverse effects*; D002675:Child, Preschool; D000077866:Clofarabine; D004314:Down Syndrome / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020258:Neurotoxicity Syndromes / Q000188:drug therapy / Q000209:etiology*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014916:Whole-Body Irradiation / Q000009:adverse effects*
chemical_list: D000227:Adenine Nucleotides; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D000077866:Clofarabine