title: Modifying chemotherapeutic management of a patient with Burkitt's lymphoma and pre-existing motor neurone disease.
abstract: OBJECTIVE
  Intensive chemotherapy for treatment of Burkitt's lymphoma (BL) - a high-grade lymphoproliferative disorder (LPD) - can cause neurotoxicity. An association between motor neurone disease (MND) and LPDs has previously been described, but there is a lack of recommendations available to guide management of such patients. This report aims to describe suitable management of BL in a patient with MND.
  
  
  METHODS
  A 66-year-old woman with a history of MND affecting her limbs was diagnosed with bulky, extranodal, high-risk gastric BL. Standard chemotherapy is with multiple non-cross-resistant cytotoxic agents. To avoid exacerbation of neuropathy, six cycles of a modified regimen was planned, aiming to minimize exposure to the most neurotoxic agents. A PET-FDG-negative remission was obtained at 12 months, without the signs of central neurotoxicity, peripheral neuropathy or muscle weakness.
  
  
  CONCLUSIONS
  High-intensity chemotherapy, minimizing known neurotoxic agents, was delivered safely and effectively in a patient with BL and pre-existing MND. More case descriptions are required to guide management decisions.
authors.affiliation: Pharmacy Department, Alfred Health, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: H
authors.initials: H
authors.lastname: Bortz
authors.affiliation: Pharmacy Department, Alfred Health, The Alfred Hospital, Melbourne, Vic., Australia.|Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: J
authors.initials: J
authors.lastname: Coutsouvelis
authors.affiliation: Pharmacy Department, Alfred Health, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: C E
authors.initials: CE
authors.lastname: Corallo
authors.affiliation: Department of Malignant Haematology and Stem Cell Transplantation, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: A
authors.initials: A
authors.lastname: Spencer
authors.affiliation: Department of Malignant Haematology and Stem Cell Transplantation, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: S
authors.initials: S
authors.lastname: Patil
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D016472:Motor Neuron Disease / Q000150:complications*; D020258:Neurotoxicity Syndromes / Q000517:prevention & control*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D012074:Remission Induction / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Burkitt's lymphoma; chemotherapy; lymphoma; motor neurone disease; neuropathy; neurotoxicity