Abstract
The central nervous system toxicity of high-dose cytosine arabinoside is well recognized, but the toxicity of cytosine arabinoside in the peripheral nervous system has been infrequently reported. A 49-year-old Japanese man was diagnosed with acute myeloid leukemia. After he achieved complete remission, he received high-dose cytosine arabinoside treatment (2 g/m2 twice a day for 5 days; total, 20 g/m2) as consolidation therapy. The first course of high-dose cytosine arabinoside resulted in no unusual symptoms, but on day 21 of the second course of treatment, the patient complained of numbness in his right foot. Electromyogram and nerve-conduction studies showed peripheral neuropathy in both peroneal nerves. This neuropathy was gradually resolving; however, after the patient received allogeneic bone marrow transplantation, the symptoms worsened, with the development of graft-versus-host disease, and the symptoms subsequently responded to methylprednisolone. Although the mechanisms of peripheral neuropathy are still unclear, high-dose cytosine arabinoside is a therapy that is potentially toxic to the peripheral nervous system, and auto/alloimmunity may play an important role in these mechanisms.
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References
WJ Baker GL Royer RB Weiss (1991) ArticleTitleCytarabine and neurologic toxicity J Clin Oncol 9 679–93 Occurrence Handle1648599 Occurrence Handle1:STN:280:By6B1Mvotl0%3D
JC Byrd RK Dodge A Carroll MR Baer C Edwards J Stamberg et al. (1999) ArticleTitlePatients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered J Clin Oncol 17 3767–75 Occurrence Handle10577848 Occurrence Handle1:STN:280:DC%2BD3c%2FksVymug%3D%3D
B Scherokman MR Filling-Katz D Tell (1985) ArticleTitleBrachial plexus neuropathy following high-dose cytarabine in acute monoblastic leukemia Cancer Treat Rep 69 1005–6 Occurrence Handle2992782 Occurrence Handle1:STN:280:BiqB1c3jsVw%3D
BL Powell RL Capizzi ES Lyerly MR Cooper (1986) ArticleTitlePeripheral neuropathy after high-dose cytosine arabinoside, daunorubicin, and asparaginase consolidation for acute nonlymphocytic leukemia J Clin Oncol 4 95–7 Occurrence Handle3001234 Occurrence Handle1:STN:280:BimD1cfgsFc%3D
A Borgeat B DeMuralt M Stalder (1986) ArticleTitlePeripheral neuropathy associated with high-dose Ara-C therapy Cancer 58 852–4 Occurrence Handle3013396 Occurrence Handle1:STN:280:BimB2cvntVw%3D Occurrence Handle10.1002/1097-0142(19860815)58:4<852::AID-CNCR2820580408>3.0.CO;2-I
NT Johnson SW Crawford M Sargur (1987) ArticleTitleAcute acquired demyelinating polyneuropathy with respiratory failure following high-dose systemic cytosine arabinoside and marrow transplantation Bone Marrow Transplant 2 203–7 Occurrence Handle3332167 Occurrence Handle1:STN:280:BiaD3c7ktFA%3D
TJ Nevill TJ Benstead CW McCormick OA Hayne (1989) ArticleTitleHorner's syndrome and demyelinating peripheral neuropathy caused by high-dose cytosine arabinoside Am J Hematol 32 314–5 Occurrence Handle2554727 Occurrence Handle1:STN:280:By%2BD2MzlsFQ%3D
M Paul D Joshua N Rahme J Pollard J Ell J Gibson et al. (1991) ArticleTitleFatal peripheral neuropathy associated with axonal degeneration after high-dose cytosine arabinoside in acute leukemia Br J Haematol 79 521–3 Occurrence Handle1661126 Occurrence Handle1:STN:280:By2D1cfptlY%3D
H Openshaw NE Slatkin AS Stein DR Hinton SJ Forman (1996) ArticleTitleAcute polyneuropathy after high dose cytosine arabinoside in patients with leukemia Cancer 78 1899–905 Occurrence Handle8909309 Occurrence Handle1:CAS:528:DyaK28XmvFylt74%3D Occurrence Handle10.1002/(SICI)1097-0142(19961101)78:9<1899::AID-CNCR9>3.0.CO;2-A
MD Winkelman JD Hines (1996) ArticleTitleCerebellar degeneration caused by high-dose cytosine arabinoside: a clinicopathological study Ann Neurol 14 520–7 Occurrence Handle10.1002/ana.410140505
AJ Aguayo JS Romine GM Bray (1975) ArticleTitleExperimental necrosis and arrest of proliferation of Schwann cells by cytosine arabinoside J Neurocytol 4 663–74 Occurrence Handle1194930 Occurrence Handle1:CAS:528:DyaE28XlsVOktg%3D%3D Occurrence Handle10.1007/BF01181629
L Montalbetti G Brambilla Pisoni G Trotti MV Calloni (1992) ArticleTitlePolyneuritis after HD Ara-C therapy for malignant lymphoma Ital J Neurol 13 85 Occurrence Handle1:STN:280:By2B3MfhsFY%3D Occurrence Handle10.1007/BF02222895
D Machover B Delmas-Marsalet SC Misra Y Gumus E Goldschmidt A Schilf et al. (2001) ArticleTitleDexamethasone, high-dose cytarabine, and oxaliplatin (DHAOx) as salvage treatment for patients with initially refractory or relapsed non-Hodgkin's lymphoma Ann Oncol 12 1439–43 Occurrence Handle11762817 Occurrence Handle1:STN:280:DC%2BD38%2FjsFakug%3D%3D Occurrence Handle10.1023/A:1012501305214
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Saito, T., Asai, O., Dobashi, N. et al. Peripheral neuropathy caused by high-dose cytosine arabinoside treatment in a patient with acute myeloid leukemia. J Infect Chemother 12, 148–151 (2006). https://doi.org/10.1007/s10156-006-0443-1
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DOI: https://doi.org/10.1007/s10156-006-0443-1