Details

Autor(en) / Beteiligte

• Mousannif, S
• Alj, L
• Sefiani, H
• Hessissen, L
• Bouatia, M

Titel

Neurotoxicity of Intrathecal Chemotherapy in Children: A Case Series

Ist Teil von

• Drug safety, 2023-11, Vol.46 (11), p.1239-1239

Ort / Verlag

Auckland: Springer Nature B.V

Erscheinungsjahr

2023

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Introduction: Intrathecal chemotherapy with antineoplastic agents is mainly used in children with acute lymphoblastic leukemia (ALL). In this disease, intrathecal rout is restricted to methotrexate (MTX), cytarabine (Ara-C)(l) Methods: This study reported clinical presentations of 4 children followed up for acute lymphoblastic leukemia (ALL) who developed neurological disorders after intrathecal chemotherapy in Pediatric Hemato-oncology department. Results: Case 1: A 7-years-old female was diagnosed with ALL, the patient received an intratechal chemotherapy consisting of methotrexate, cytarabine and corticosteroids, who exhibited later a meningeal syndrome, paraparesis followed by paraplegia, sphincter disorders, ascending paralysis and respiratory disorders. Unfortunately, the patient died 2 months later. The imputability study using the French method revealed an 12 score for the 3 drugs. Case 2: A 4-years-old female was diagnosed with ALL standard risk, the patient received an intratechal chemotherapy consisting of methotrexate, cytarabine and corticosteroids, who developed stiff neck, paresthesia of lower limbs, axial hypotonia, sphincter disorders, paraplegia, abnormal movements. Sadly the patient died later. The imputability study using the French method revealed an 12 score for the 3 drugs. Case 3: A 9-years-old male was diagnosed with ALL hight risk, the patient received an intratechal chemotherapy consisting of methotrexate, who presented a stiff neck, axial pain, paresthesia of both lower limbs, then paraplegia of both limbs, and acute urinary retention then incontinence. Unfortunately, the patient died a week later. The imputability study using the French method revealed an 12 score for methotrexate. Case 4: A 16-years-old male was diagnosed with ALL, the patient received an intratechal chemotherapy consisting of methotrexate, cytarabine and corticosteroids, who exhibited paraparesis associated with sphincter disorders. Unfortunately, the patient died later. The imputability study using the French method revealed an 12 score for the 3 drugs. Conclusion: The neurotoxicity of the 3 drugs used in intrathecal administration is widely described in the scientific literature. The intrathecal route, repeated injections, high doses and cumulative doses, certain types of excipients such as benzyl alcohol, and combination with other neurotoxic drugs, are all factors favoring the neurotoxicity of these drugs, and must be taken into consideration.