Fatal leukoencephalopathy after reduced-intensity allogeneic stem cell transplantation.

Abstract

BACKGROUND:

Toxicity associated with immunosuppression and conditioning regimens represents a common cause of neurological complications after allogeneic stem cell transplantation.

CASE REPORT:

We present a 56-year-old female patient with refractory acute lymphoblastic leukemia undergoing reduced-intensity conditioning with fludarabine, BCNU and melphalan followed by matched-sibling allogeneic stem cell transplantation. Under immunosuppressive treatment with cyclosporine A (CSA) the patient developed early-onset (day +33) and ultimately fatal leukoencephalopathy.

DISCUSSION:

As fludarabine and CSA represent two key substances of today's reduced-intensity conditioning regimens we raise the question of whether CSA, fludarabine or a combination of both led to this outcome and discuss differential diagnoses.

• Authors: Stephan Mielke, Karin Potthoff, Friedrich Feuerhake, Thorsten A Bley, Marisa Windfuhr, Hartmut Bertz, Jürgen Finke
• Journal: Onkologie (Onkologie) Vol. 30 Issue 1-2 Pg. 49-52 (Feb 2007) ISSN: 0378-584X [Print] Switzerland
• PMID: 17264526 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Immunosuppressive Agents
• Cyclosporine
• Vidarabine
• fludarabine
• Melphalan
• Carmustine

Topics

• Antineoplastic Agents
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Carmustine (administration & dosage, adverse effects)
• Combined Modality Therapy
• Cyclosporine (administration & dosage, adverse effects)
• Demyelinating Diseases (chemically induced, diagnosis)
• Fatal Outcome
• Female
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Melphalan (administration & dosage, adverse effects)
• Middle Aged
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, drug therapy, surgery)
• Risk Assessment
• Stem Cell Transplantation
• Vidarabine (administration & dosage, adverse effects, analogs & derivatives)