Multifocal central nervous system demyelination and Lhermitte's phenomenon secondary to combination chemotherapy for chronic lymphocytic leukaemia

J Hafner; K Kumar; S Mulligan; K Ng

doi:10.1016/j.jns.2013.12.032

Multifocal central nervous system demyelination and Lhermitte's phenomenon secondary to combination chemotherapy for chronic lymphocytic leukaemia

J Neurol Sci. 2014 Mar 15;338(1-2):218-9. doi: 10.1016/j.jns.2013.12.032. Epub 2013 Dec 31.

Authors

J Hafner¹, K Kumar¹, S Mulligan², K Ng³

Affiliations

¹ Department of Neurology and Clinical Neurophysiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; The University of Sydney, NSW 2006, Australia.
² Department of Haematology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; The University of Sydney, NSW 2006, Australia.
³ Department of Neurology and Clinical Neurophysiology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; The University of Sydney, NSW 2006, Australia. Electronic address: karl.ng@sydney.edu.au.

PMID: 24468536
DOI: 10.1016/j.jns.2013.12.032

Abstract

The CRF regime (cyclophosphamide, rituximab and fludarabine) is used for the treatment of chronic lymphocytic leukaemia. We report a case of diffuse CNS demyelination following treatment with CRF, presenting with Lhermitte's phenomenon, and imaging and neurophysiological evidence of demyelination. Fludarabine is the most likely causative agent, although CNS demyelination has not been previously described in low dose therapy.

Keywords: Chemotherapy; Chronic lymphocytic leukaemia; Demyelination; Evoked response; Fludarabine; Lhermitte's sign.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Monoclonal, Murine-Derived / adverse effects
Cyclophosphamide / adverse effects
Hamartoma Syndrome, Multiple / chemically induced*
Hereditary Central Nervous System Demyelinating Diseases / drug therapy*
Humans
Immunologic Factors / adverse effects*
Leukemia, Lymphocytic, Chronic, B-Cell / chemically induced*
Magnetic Resonance Imaging
Male
Middle Aged
Rituximab
Vidarabine / adverse effects
Vidarabine / analogs & derivatives

Substances

Antibodies, Monoclonal, Murine-Derived
Immunologic Factors
Rituximab
Cyclophosphamide
Vidarabine
fludarabine