• Internal medicine · Feb 2024

    Case Reports

    Irreversible intrathecal chemotherapy-induced myelopathy in a patient with diffuse large B-cell lymphoma: A case report.

    • Yuri Hirakawa, Akihito Kitao, Marika Watanabe, Sakuya Matsumoto, Ryohei Komaki, Rina Sakai, Kohei Morimoto, Kimikazu Yakushijin, and Hironobu Minami.
    • Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan.
    • Intern. Med. 2024 Feb 15; 63 (4): 547551547-551.

    AbstractIntrathecal chemotherapy is often administered for prophylaxis and treatment of central nervous system involvement in hematological malignancies. However, it may rarely cause neurotoxicity as a side effect. We herein report a 74-year-old woman with diffuse large B-cell lymphoma including a spinal lesion. She received systemic and intrathecal chemotherapy. After five doses of intrathecal chemotherapy, she developed intrathecal chemotherapy-induced myelopathy. Intrathecal treatment was discontinued, and she was administered vitamin B12 and folic acid, along with steroid pulses. However, her symptoms did not improve. Intrathecal chemotherapy-induced myelopathy is rare, but may be irreversible; therefore, clinicians should be aware of this potential complication.

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