Document Detail

Reversible posterior leukoencephalopathy syndrome after treatment of diffuse large B-cell lymphoma.
MedLine Citation:
PMID:  17341901     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We report the case of a patient who experienced a severe neurologic complication after treatment of diffuse large B-cell lymphoma. CASE REPORT: A 62-year old patient was diagnosed with a diffuse large B-cell lymphoma and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone under prophylactic G-CSF substitution. After the second cycle she developed severe neurologic complications with generalized seizures and soporous condition. The MRI showed bilateral areas of signal hyperintensity in the subcortical and cortical regions in both hemispheres, consistent with the diagnosis of a reversible posterior leukoencephalopathy syndrome. The patient was under surveillance in intensive care, and a meticulous control of the blood pressure was performed. She fully recovered within a few days, and MRI changes normalized. Antineoplastic treatment had to be continued, and we chose a combination of rituximab, doxorubicin, etoposide, and prednisone. CONCLUSIONS: The reversible posterior leukoencephalopathy syndrome is believed to be the result of altered cerebral autoregulation with impaired blood flow control and resultant endothelial damage caused by different situations and agents. Several chemotherapy agents have been described in association with the syndrome. However, little is known about the prevalence of the syndrome and the follow-up of these patients, especially their further treatment.
Mark D Haefner; R Daniele Siciliano; Lucas A Widmer; Barbara M Vogel Wigger; Sonia Frick
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-02-02
Journal Detail:
Title:  Onkologie     Volume:  30     ISSN:  0378-584X     ISO Abbreviation:  Onkologie     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-07     Completed Date:  2007-05-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7808556     Medline TA:  Onkologie     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  138-40     Citation Subset:  IM    
Institut für med. Onkologie und Hämatologie, Stadtspital Triemli, Zürich, Switzerland.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / adverse effects*,  therapeutic use
Brain Diseases / chemically induced*,  diagnosis
Cecal Neoplasms / drug therapy*,  surgery
Cerebral Cortex / pathology*
Chemotherapy, Adjuvant
Combined Modality Therapy
Diagnosis, Differential
Hypertensive Encephalopathy / chemically induced*,  diagnosis
Lymphoma, B-Cell / drug therapy*,  surgery
Lymphoma, Large B-Cell, Diffuse / drug therapy*,  surgery
Magnetic Resonance Imaging
Middle Aged
Remission, Spontaneous
Comment In:
Onkologie. 2007 Mar;30(3):90-1   [PMID:  17341892 ]

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