Nelarabine-associated myelopathy in a patient with acute lymphoblastic leukaemia: Case report
| Autor: | Neus Amer-Salas, Gonzalo González-Morcillo, Juan Manuel Rodríguez-Camacho, Antonia Cladera-Serra |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Purine analogue Precursor T-Cell Lymphoblastic Leukemia-Lymphoma Spinal Cord Diseases 03 medical and health sciences Myelopathy 0302 clinical medicine Internal medicine Medicine Humans Pharmacology (medical) business.industry Lymphoblastic lymphoma T-cell acute lymphoblastic leukaemia medicine.disease 030220 oncology & carcinogenesis Nelarabine Lymphoblastic leukaemia Female Neurotoxicity Syndromes Arabinonucleosides business 030215 immunology medicine.drug |
| Zdroj: | Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 27(1) |
| ISSN: | 1477-092X |
| Popis: | Introduction Nelarabine is a purine analogue approved for the treatment of patients with T-cell lymphoblastic lymphoma and T-cell acute lymphoblastic leukaemia (T-ALL) that have relapsed or are refractory to two previous chemotherapy regimens. Adverse reactions to nelarabine include neurological toxicity, the pathophysiological mechanisms of which are unknown, although the administration of intrathecal therapy at therapeutic doses given concomitantly with high-dose systemic chemotherapy that crosses the blood–brain barrier may potentiate neurotoxicity. Case report We report a case of a 29-year-old woman with a diagnosis of relapsed T-ALL who developed severe myelopathy and polyneuropathy of toxic origin that led to paraplegia, upper-limb paresis, and dysautonomia after the first cycle of nelarabine. Management and outcome Rehabilitation and pharmacological treatments were initiated early, but no evidence of a significant clinical change was obtained. Discussion Neurotoxicity is a dose-dependent side effect of nelarabine. It is therefore important to consider previously administered neurotoxic drugs before using nelarabine and to monitor patients closely so as to be able to act promptly in case of toxicity. In accordance with the data obtained and based on the Naranjo algorithm, the adverse reaction could be considered possible. |
| Databáze: | OpenAIRE |
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