1. Reversible posterior leukoencephalopathy syndrome after treatment of diffuse large B-cell lymphoma
- Author
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Sonia Frick, Mark D. Haefner, Barbara M. Vogel Wigger, Lucas Widmer, and R. Daniele Siciliano
- Subjects
Cancer Research ,Pathology ,medicine.medical_specialty ,Lymphoma, B-Cell ,medicine.medical_treatment ,Remission, Spontaneous ,Cecal Neoplasms ,Reversible posterior leukoencephalopathy syndrome ,Diagnosis, Differential ,Hypertensive Encephalopathy ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Cerebral Cortex ,Chemotherapy ,Brain Diseases ,medicine.diagnostic_test ,business.industry ,Neurologic complication ,Magnetic resonance imaging ,Hematology ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Magnetic Resonance Imaging ,Lymphoma ,Oncology ,Chemotherapy, Adjuvant ,Female ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma ,After treatment - Abstract
We report the case of a patient who experienced a severe neurologic complication after treatment of diffuse large B-cell lymphoma.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.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.
- Published
- 2007