Interferon-induced CNS toxicity

Reactions ◽  
1988 ◽  
Vol 232 (1) ◽  
pp. 3-3
Keyword(s):  
Cns Toxicity

scholarly journals Radiation induced CNS toxicity – molecular and cellular mechanisms

2001 ◽  
Vol 85 (9) ◽  
pp. 1233-1239 ◽  
Author(s):  
C Belka ◽  
W Budach ◽  
R D Kortmann ◽  
M Bamberg
Keyword(s):  
Cellular Mechanisms ◽  
Radiation Induced ◽  
Cns Toxicity

CNS Toxicity Associated with Intraventricular Injection of Cefazolin

1990 ◽  
pp. 101-101
Author(s):  
John P. Manzella ◽  
Ronald L. Paul ◽  
Ivan Butler
Keyword(s):  
Intraventricular Injection ◽  
Cns Toxicity

Cyproheptadine Dependence Associated with an Atypical Somatoform Disorder

1987 ◽  
Vol 32 (2) ◽  
pp. 143-145 ◽  
Author(s):  
John L. Craven ◽  
Gary M. Rodin
Keyword(s):  
Cognitive Impairment ◽  
Weight Gain ◽  
Somatoform Disorder ◽  
Pharmacological Effects ◽  
Continued Use ◽  
Cns Toxicity

A case is described of cyproheptadine dependence in a woman with a persistent belief that she was too thin, and diagnosed with an atypical somatoform disorder. The cyproheptadine was initially prescribed to promote weight gain but its continued use seemed related to other psychological and/ or pharmacological effects. Cognitive impairment was present, possibly as a result of the longstanding cyproheptadine abuse. There have been no previous reports of cyproheptadine dependence or of CNS toxicity from its long-term use.

Delayed toxicity of whole brain radiotherapy (WBRT) in germ cell tumor (GCT) patients with central nervous system (CNS) metastases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15511-15511
Author(s):  
D. M. Doyle ◽  
L. H. Einhorn
Keyword(s):  
Germ Cell ◽  
Young Patients ◽  
Cerebral Atrophy ◽  
Whole Brain Radiotherapy ◽  
High Serum ◽  
Collaborative Group ◽  
Cns Metastases ◽  
Brain Radiotherapy ◽  
Receptive Aphasia ◽  
Cns Toxicity

15511 Background: CNS metastases are uncommon in GCT. Incidence is 2–3% and is usually associated with extensive pulmonary metastases and/or high serum human chorionic gonadotropin levels. CNS metastases have been managed with WBRT and concomitant cisplatin-based combination chemotherapy. Our prior publication did not observe serious CNS toxicity (Int J Rad Oncol Biol Phys 22:17–22, 1991). Methods: We observed 5 patients with delayed CNS toxicity. Initial diagnosis was 1981 through 2003. Median age 23 years (range 21–34). All 5 patients had advanced disease by the International Germ Cell Consensus Collaborative Group. Three of five patients had CNS metastases at the time of diagnosis, and two patients relapsed with CNS metastases. These 5 patients received WBRT 4,000–5,000 cGy in 18- 28 fractions concurrently with cisplatin-based chemotherapy. Results: All five patients developed delayed symptoms consistent with progressive multifocal leukoencephalopathy (PMLE), including seizures, hemiparesis, expressive and receptive aphasia, cranial neuropathies including facial droop, tremors, headaches, blindness, dementia, decreased level of consciousness, ataxia, and parasthesias. Median time from WBRT to CNS symptoms was 72 months (range 9–228 months). Brain imaging revealed multiple abnormalities consistent with gliosis and diffuse cerebral atrophy. One patient was diagnosed with glioblastoma multiforme in the area of radiation-induced gliosis. 3 of 5 patients had progressive symptoms, and the other 2 had stable symptoms. Treatment with surgery and steroids had modest benefit. The PMLE resulted in significant debility in all five patients, resulting in death (2 patients), loss of work, steroid-induced morbidity, and recurrent hospitalizations. Conclusions: WBRT is not innocuous in young patients with GCT and can cause late CNS toxicity. We are now cautious about the use of WBRT and reserve it for multiple CNS metastases that are symptomatic or resistant to chemotherapy. No significant financial relationships to disclose.

Effect of azole antifungal therapy on vincristine toxicity in childhood acute lymphoblastic leukemia

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10049-10049
Author(s):  
D. M. Te Loo ◽  
R. M. van Schie ◽  
P. M. Hoogerbrugge
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Side Effects ◽  
De Novo ◽  
Case Reports ◽  
Lymphoblastic Leukemia ◽  
Toxic Encephalopathy ◽  
Rank Test ◽  
Severe Toxicity ◽  
Peripheral Neurotoxicity ◽  
Cns Toxicity

10049 Background: Vincristine is one of the corner stitches in the treatment of children with acute lymphoblastic leukemia (ALL). Constipation and other peripheral and central neurotoxicities are the most common side effects. Drugs interfering with the metabolism of vincristine might potentiate these side effects. A group of drugs that interact with the metabolism of vincristine are azoles. Several case reports suggest that co-administration of azoles and vincristine lead to increased toxicity. A comparative study exploring toxicity in patients receiving vincristine with and without azoles, is lacking. For this reason, we retrospectively analyzed neurotoxicity induced by vincristine with (n = 20) and without (n = 20) co-administration of azoles in the same patient group. Methods: In total, twenty pediatric patients with de novo ALL were included in this study. Vincristine toxicity was graded retrospectively according to the National Cancer Institute toxicity scale without information considering comedication. Statistical analysis was performed using the Wilcoxon Signed Rank test and McNemar test. Results: Patients receiving vincristine in combination with prophylactic azole treatment experienced significantly more complaints of constipation and peripheral neurotoxicity (P = 0.001 and P< 0.001, respectively). Three patients (15%) treated with azole therapy developed severe toxicity and needed treatment at the pediatric intensive care unit. Vincristine induced CNS toxicity (convulsions, toxic encephalopathy and SIADH) was seen in 6 patients (30%). All these patients were treated with vincristine in combination with an azole. CNS toxicity was not observed in patients receiving vincristine alone (P = 0 .014). Because of severe toxicities, vincristine treatment was significantly reduced (50% of normal dose) in several patients. Conclusions: This study shows that vincristine toxicity is significantly increased when combined with azole treatment and even can be life threatening. Therefore we advise to avoid the combination of azole and vincristine treatment in patients with ALL. No significant financial relationships to disclose.

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