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Fatal leukoencephalopathy in a patient with non-Hodgkin's lymphoma treated with CHOP chemotherapy and high-dose steroids

, : Fatal leukoencephalopathy in a patient with non-Hodgkin's lymphoma treated with CHOP chemotherapy and high-dose steroids. American Journal of the Medical Sciences 315(3): 202-207

Leukoencephalopathy syndromes encompass a variety of neurologic abnormalities that affect cerebral white matter. Known etiologies include malignant hypertension, eclampsia, renal failure, CNS infection, and drug therapy with cyclosporine, tacrolimus (FK506) and interferon-alpha. Symptoms vary according to sites of involvement; they include altered mentation, visual disturbances, focal neurologic signs, and seizures. Characteristic radiologic findings are hypodense areas without contrast enhancement on CT and an increased T2 signal on MRI. The hypodense areas are often symmetric. The clinical symptoms and neuroimaging abnormalities are often reversible with treatment of the underlying condition or removal of the offending drug. We describe a patient with non-Hodgkin's lymphoma treated with conventional cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy and high-dose steroids who developed a rapidly progressive fatal leukoencephalopathy. Her neurologic symptom s and findings on CT are consistent with reported cases of leukoencephalopathy; however, in this instance, the syndrome was not reversible and was ultimately fatal. None of the previously described etiologies could be demonstrated in association with the patient's illness. There are no prior reports of fatal leukoencephalopathy in adult patients treated with standard-dose CHOP. We believe the concurrent immunosuppression from chemotherapy and high-dose steroids resulted in this patient's fatal complication.


PMID: 9519935

DOI: 10.1016/s0002-9629(15)40307-6

Other references

Hu, S.Y.; Wang, M.S.; Hsu, L.Y., 1977: Electron microscope observations on the micro sporogenesis in male sterile and its maintainer lines of wheat. The process of microsporogenesis was divided into 3 successive stages: the shrinking stage, the small vacuole stage and the large vacuole stage. Abortion of the microspores of the male-sterile line occurred mainly in the large vacuole stage, when...

Forsyth, W.G.C.; Rombouts, J.E., 1951: Our approach to the study of cocoa fermentation. From studies made by the Colonial Microbiological Research Institute, Trinidad, it is concluded that the fermentation of the cotyledons of cocoa beans takes place in the almost complete absence of oxygen. The most striking chemical change is the c...

Studer, H.P.; Pradhan, K.R.; Reinstein, D.Z.; Businaro, E.; Archer, T.J.; Gobbe, M.; Roberts, C.J., 2015: Biomechanical Modeling of Femtosecond Laser Keyhole endokeratophakia Surgery. To apply a finite element model to endokeratophakia and evaluate anterior and posterior corneal surface changes. Spatial elevation data (Pentacam HR; Oculus, Wetzlar, Germany) were obtained for the front and back corneal surfaces of an eye prior t...

Kolesnikova, L.N., 1961: Standards for applanation tonometry and tonography according to A. I. Dashevskii. Vestnik Oftalmologii 74: 23-26

Lang, E., 1951: Results with penicillin-sulfonamide powder in traumatic surgery. Medizinische Klinik 46(43): 1133-1134

Anonymous, 2011: Abundance thresholds and the underlying ecological processes Field volesMicrotus agrestisin a fragmented landscape. Field voles (Microtus agrestis) were trapped in 14 field margins and their behavioural and demographic parameters measured. Strong support was found for thresholds in margin width below which vole abundance was extremely low. Narrow margins were m...

Von Knebel Doeberitz, Magnus, 2002: New markers to identify HPV-transformed dysplastic cervical epithelia. Acta Cytologica 46(1 Supplement): 156, January-February

Ferone, D.; Semino, C.; Boschetti, M.; Cascini, G.Lucio.; Minuto, F.; Lastoria, S., 2005: Initial staging of lymphoma with octreotide and other receptor imaging agents. Somatostatin receptor scintigraphy is useful in diagnosing tumors with increased expression of somatostatin receptors. The correct use of this technique reveals the localization of neuroendocrine primary tumors and unknown metastases in approximat...

Cunha,; Rocha,; Pereira, Fábio.Payão.; Blasbalg, R.; Baroni, R.Hueb., 2015: Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis. A pancreatite aguda é uma condição inflamatória causada por ativação intracelular e extravasamento inapropriado de enzimas proteolíticas que determinam destruição do parênquima pancreático e dos tecidos peripancreáticos. Consiste em um...

Colom, C., 1984: Hallazgo de tintinnidos en las calizas del Muschelkalk y en las calizas margosas del Lias Superior de Mallorca. In this report 11 new species of Tintinnids from the Muschelkalk and the Upper Lias are described Tintinnopsella-liassina, Amphorellina delicatula, Lorenziella maioricensis, Codonella sphaerica, Crassicollaria calpionelloides, Stenosemellopsis sim...