Fatal neurotoxicity in a patient with down syndrome treated with chemotherapy, irradiation, stem cell transplant, and clofarabine.
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.
Johnston
Donna L
DL
Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H8L1, Canada. djohnston@cheo.on.ca
Bains
Tejinder
T
Mandel
Karen
K
Klaassen
Robert
R
Halton
Jacqueline
J
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*
D000227:Adenine Nucleotides; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D000077866:Clofarabine