Acute ascending motoric paraplegia following intrathecal chemotherapy for treatment of acute lymphoblastic leukemia in children: case reports and review of the literature.

Full Abstract

Severe side effects of chemotherapy in pediatric patients with acute lymphoblastic leukemia are rare, but well-known. We present two pediatric patients who developed ascending motoric paraplegia (AMP) following intrathecal chemotherapy. Both patients suffered from progressive weakness of their lower extremities, neurogenic bladder dysfunction, autonomous neural dysregulation and minor sensory deficits. Despite an initially similar clinical picture, progression and outcome were fairly different. There is convincing evidence that AMP is caused by spinal cord toxicity of intrathecally applied toxic agents such as cytarabin and/or methotrexate leading to spinal demyelinisation as demonstrated by elevated myelin basic protein in cerebrospinal fluid.

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Author information

Author/s: Rolf, N (N); Boehm, H (H); Kaindl, A M (AM); Lauterbach, I (I); Suttorp, M (M);

Affiliation: University Children's Hospital, Technical University of Dresden, Germany. nina.rolf(-atsign-)uniklinikum-dresden.de

Journal and publication information

Publication Type: Case Reports; Comparative Study; Journal Article

Journal: Klinische Pädiatrie (Klin Padiatr), published in Germany. (Language: eng)

Reference: -2006 Nov-Dec; vol 218 (issue 6) : pp 350-4

Dates: Created 2006/11/02; Completed 2007/01/26; Revised 2007/11/15;

PMID: 17080338, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

6-Mercaptopurine - administration & dosage; therapeutic use
Acute Disease
Administration, Oral
Adolescent
Antimetabolites, Antineoplastic - administration & dosage; adverse effects; therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Child
Disease Progression
Electroencephalography

Female
Humans
Injections, Spinal - adverse effects
Magnetic Resonance Imaging
Male
Methotrexate - administration & dosage; adverse effects; therapeutic use
Paraplegia - blood; chemically induced; diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Time Factors

Associated Chemicals: Antimetabolites, Antineoplastic (0) ; 6-Mercaptopurine (50-44-2) ; Methotrexate (59-05-2)

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