Current Oncology Reports

, Volume 10, Issue 1, pp 86–91 | Cite as

Reversible posterior leukoencephalopathy syndrome in cancer

Article
First Online:

Abstract

Reversible posterior leukoencephalopathy syndrome (RPLS) is a subacute neurological syndrome typically manifesting with headache, cortical blindness, and seizures. The syndrome is associated with risk factors such as malignant hypertension, eclampsia, and renal failure. Numerous case reports depict its occurrence in cancer patients. The direct causal relationship for the mechanism of RPLS in cancer patients has not yet been defined. Cytotoxic chemotherapy may cause direct endothelium damage, which would impact the blood-brain barrier. Chemotherapies also cause elevations in blood pressure; this is significant because RPLS onset may be solely related to hypertension. An increased number of case reports involving new targeted agents suggests that RPLS incidence may increase in the future. Agents such as bevacizumab and sorafenib have been implicated in new cases of RPLS.

Keywords

Vascular Endothelial Growth Factor Bevacizumab Sorafenib Sirolimus Eclampsia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Hinchey J, Chaves C, Appignani B, et al.: A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996, 334:494–500.PubMedCrossRefGoogle Scholar
  2. 2.
    Glusker P, Recht L, Lane B: Reversible posterior leukoencephalopathy syndrome and bevacizumab. N Engl J Med 2006, 354:980–981.PubMedCrossRefGoogle Scholar
  3. 3.
    Magnano M, Bush T, Herrera I, et al.: Reversible posterior leukoencephalopathy in patients with systemic lupus erythematous. Semin Arthritis Rheum 2006, 35:396–402.PubMedCrossRefGoogle Scholar
  4. 4.
    Govindarajan R, Adusumilli J, Baxter DL, et al.: Reversible posterior leukoencephalopathy syndrome induced by raf kinase inhibitor bay 43-9006. J Clin Oncol 2006, 24:e48.PubMedCrossRefGoogle Scholar
  5. 5.
    Stott V, Hurrell M, Anderson T, et al.: Reversible posterior leukoencephalopathy syndrome; a misnomer reviewed. Intern Med J 2005, 35:83–90.PubMedCrossRefGoogle Scholar
  6. 6.
    Garg RK: Posterior leukoencephalopathy syndrome. Postgrad Med J 2001, 77:24–28.PubMedCrossRefGoogle Scholar
  7. 7.
    Covarrubias D, Luetmer P, Campeau N: Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images. AJNR Am J Neuroradiol 2002, 23:1038–1048.PubMedGoogle Scholar
  8. 8.
    Allen J, Adlakha A, Bergethon P: Reversible posterior leukoencephalopathy syndrome after bevacizumab/FOLFIRI regimen for metastatic colon cancer. Arch Neurol 2006, 63:1475–1478.PubMedCrossRefGoogle Scholar
  9. 9.
    Norden A, Batchelor T: Reversible posterior leukoencephalopathy syndrome. Onkologie 2007, 30:90–91.PubMedCrossRefGoogle Scholar
  10. 10.
    Sander T, Clayman D, Sanchez-Ramos L, et al.: Brain in eclampsia: MR imaging with clinical correlation. Radiology 1991, 180:475–478.Google Scholar
  11. 11.
    Strandgaard S, Paulson O: Cerebral autoregulation. Stroke 1994, 15:413–417.Google Scholar
  12. 12.
    Edvinsson L, Oman C, Sjoberg N: Autonomic nerves, mast cells, and amine receptors in human brain vessels. Brain Res 1976, 15:377–393.CrossRefGoogle Scholar
  13. 13.
    Benigni A, Morigi M, Perico N, et al.: The acute effect of FK506 and cyclosporine on endothelial cell function and renal vascular resistance. Transplantation 1992, 54:775–780.PubMedCrossRefGoogle Scholar
  14. 14.
    Fogo A, Hakim R, Sugiura M, et al.: Severe endothelial injury in a renal transplant patient receiving cyclosporine. Transplantation 1990, 49:1190–1192.PubMedCrossRefGoogle Scholar
  15. 15.
    Miyazaki Y, Tajima Y, Sodo K, et al.: Hodgkin’s disease related central nervous system angiopathy presenting as reversible posterior leukoencephalopathy. Intern Med 2004, 43:900–901.CrossRefGoogle Scholar
  16. 16.
    Rangi PS, Partridge W, Newlands ES, Waldman AD: Posterior reversible leukoencephalopathy syndrome: a possible late interaction between cytotoxic agents and general anesthesia. Neuroradiology 2005, 47:586–590.PubMedCrossRefGoogle Scholar
  17. 17.
    Ozcan C, Wong SJ, Hari P: Reversible posterior leukoencephalopathy and bevacizumab. N Engl J Med 2006, 354:980–982.PubMedCrossRefGoogle Scholar
  18. 18.
    Paul F, Aktas O, Dieste FJ, et al.: Reversible posterior leukoencephalopathy after chemotherapy with cisplatin and 5-FU [in German]. Nervenarzt 2006, 77:706–710.PubMedCrossRefGoogle Scholar
  19. 19.
    Connolly RM, Doherty CP, Beddy P, O’Byrne K: Chemotherapy induced reversible posterior leukoencephalopathy syndrome. Lung Cancer 2007, 56:459–463.PubMedCrossRefGoogle Scholar
  20. 20.
    Haefner M, Siciliano R, Widmer L, et al.: Reversible posterior leukoencephalopathy after treatment of diffuse large B cell lymphoma. Onkologie 2007, 30:138–140.PubMedCrossRefGoogle Scholar
  21. 21.
    Bauwens D, Hanston P, Laterre PF, et al.: Recurrent seizures and sustained encephalopathy associated with dimethylsulfoxide-preserved stem cell infusion. Leuk Lymphoma 2005, 46:1671–1679.PubMedCrossRefGoogle Scholar
  22. 22.
    Zhang SZ, Wang ZH, Hu HS: Effect of intra-arterial perfusion of cisplatin combined with concomitant radiation therapy on the healing of microvasculature anastomoses: an experimental study in rabbits [in Chinese]. Shanghai Kou Qiang Yi Xue 2005, 14:490–494.PubMedGoogle Scholar
  23. 23.
    Ito Y, Arahata Y, Goto Y, et al.: Cisplatin neurotoxicity presenting as reversible posterior leukoencephalopathy syndrome. AJNR Am J Neuroradiol 1998, 19:415–417.PubMedGoogle Scholar
  24. 24.
    Walker RW, Rosenblum MK, Kempin SJ, Christian MC: Carboplatin associated thrombotic microangiopathic hemolytic anemia. Cancer 1989, 64:1017–1020.PubMedCrossRefGoogle Scholar
  25. 25.
    Divix L, Libura M, Libura J, et al.: In vitro toxicity studies with mitomycin and bleomycin on endothelium cells. Anticancer Drugs 1997, 9:859–868.Google Scholar
  26. 26.
    Tam C, Galanos J, Seymour J, et al.: Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for malignancies. Am J Hematol 2004, 77:72–76.PubMedCrossRefGoogle Scholar
  27. 27.
    Delanty N, Vaughan C, Frucht S, Stubgen P: Erythropoietin-associated hypertensive posterior leukoencephalopathy. Neurology 1997, 49:686–689.PubMedGoogle Scholar
  28. 28.
    Irvin W, MacDonald G, Smith JK, Kim WY: Dexamethasone-induced posterior reversible encephalopathy syndrome. J Clin Oncol 2007, 11:2484–2485.CrossRefGoogle Scholar
  29. 29.
    Bodkin C, Eidelman H: Sirolimus induced posterior reversible encephalopathy. Neurology 2007, 68:2039–2040.PubMedCrossRefGoogle Scholar
  30. 30.
    Serkova N, Christian U, Flogel U, et al.: Assessment of the mechanism of astrocyte swelling induced by the macrolide immunosuppressant sirolimus using multinuclear nuclear magnetic resonance spectroscopy. Chem Res Toxicol 1997, 10:1359–1363.PubMedCrossRefGoogle Scholar
  31. 31.
    Hudes G, Carducci M, Tomczak P, et al.: Temsirolimus, interferon alfa, or both for advanced renal cell carcinoma. N Engl J Med 2007, 356:2271–2281.PubMedCrossRefGoogle Scholar
  32. 32.
    Levine R, Karumanchi S: Circulating angiogenic factors in preeclampsia. Clin Obstet Gynecol 2005, 48:372–386.PubMedCrossRefGoogle Scholar
  33. 33.
    Motzer R, Bukowski R: Targeted therapy for metastatic renal cell carcinoma. J Clin Oncol 2006, 24:5601–5608.PubMedCrossRefGoogle Scholar
  34. 34.
    Ledingham J, Rajagopalan B: Cerebral complications of accelerated hypertension. Q J Med 1979, 48:25–41.PubMedGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.Division of Hematology/OncologyUniversity of Virginia Health SystemCharlottesvilleUSA

Personalised recommendations