Clinical and imaging features of fludarabine neurotoxicity

Michael S Lee, Alexander M McKinney, Jeffrey R. Brace, Karen Santacruz

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Neurotoxicity from intravenous fludarabine is a rare but recognized clinical entity. Its brain imaging features have not been extensively described. Three patients received 38.5 mg or 40 mg/m per day fludarabine in a 5-day intravenous infusion before bone marrow transplantation in treatment of hematopoietic malignancies. Several weeks later, each patient developed progressive neurologic decline, including retrogeniculate blindness, leading to coma and death. Brain MRI showed progressively enlarging but mild T2/FLAIR hyperintensities in the periventricular white matter. The lesions demonstrated restricted diffusion but did not enhance. Because the neurotoxicity of fludarabine appears long after exposure, neurologic decline in this setting is likely to be attributed to opportunistic disease. However, the imaging features are distinctive in their latency and in being mild relative to the profound clinical features. The safe dose of fludarabine in this context remains controversial.

Original languageEnglish (US)
Pages (from-to)37-41
Number of pages5
JournalJournal of Neuro-Ophthalmology
Volume30
Issue number1
DOIs
StatePublished - Mar 1 2010

Fingerprint Dive into the research topics of 'Clinical and imaging features of fludarabine neurotoxicity'. Together they form a unique fingerprint.

Cite this