Drug-induced aseptic meningitis in a Ph+ ALL patient with meningeal involvement

Beaumont, Anne-Lise; Suner, Ludovic

doi:10.1182/blood.2019004195

Cited by 3 publications

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“…In addition, we reviewed the literature on common chemotherapy and targeted drugs that can induce aseptic meningitis in hematological diseases ( Table 3 ). Currently, except for the case reported herein, 10 cases of DIAM have been reported, including a total of 13 patients ( Thordarson and Talstad, 1986 ; Flasshove et al, 1992 ; van den Berg et al, 2001 ; Pease et al, 2001 ; Lin et al, 2009 ; Imataki et al, 2014 ; Vey et al, 2016 ; Reddy et al, 2018 ; Kako et al, 2019 ; Beaumont and Suner, 2020 ). The median patient age is 33 (interquartile range, 20.3–56.8) years, and the female patients are dominant (7/11, 63.6%, sexes of two patients were not reported).…”

Section: Discussionmentioning

confidence: 98%

Zanubrutinib-induced aseptic meningitis: a case report and literature review

Yang,

Wang,

Zhong

et al. 2023

Front. Pharmacol.

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Zanubrutinib is a Bruton tyrosine kinase (BTK) inhibitor used in B cell malignancy treatment and is generally well tolerated in most patients. Zanubrutinib-induced aseptic meningitis is currently not reported. Herein, we present the first case of zanubrutinib-induced aseptic meningitis. A 33-year-old woman was diagnosed with relapsed/refractory follicular lymphoma and subsequently developed aseptic meningitis after receiving zanubrutinib treatment. We reviewed the literature and uncovered the lack of current reports on zanubrutinib or other BTK inhibitor-induced aseptic meningitis. Moreover, we summarized cases on aseptic meningitis induced by common chemotherapy and targeted drugs used for hematological diseases. Drug-induced aseptic meningitis (DIAM) is a drug-induced meningeal inflammation. The possible pathogenesis is the direct stimulation of the meninges via intrathecal injection of chemotherapy drugs and immune hypersensitivity response caused by immunosuppressive drugs. It is more common in women with immune deficiency and mainly manifests as persistent headache and fever. Cerebrospinal fluid examinations mainly demonstrate a significant increase in cells and proteins. DIAM diagnosis needs to exclude bacterial, fungal, viral, and tuberculosis infections; neoplastic meningitis; and systemic diseases involving the meninges. The prognosis of DIAM is usually favorable, and physicians should detect and stop the causative drug. In conclusion, zanubrutinib-induced aseptic meningitis is a rare but serious complication, and physicians should be promptly aware of this adverse event to avoid serious consequences.

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Section: Discussionmentioning

confidence: 98%

Zanubrutinib-induced aseptic meningitis: a case report and literature review

Yang,

Wang,

Zhong

et al. 2023

Front. Pharmacol.

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“…In immunocompromised individuals, meningitis could be caused by atypical organisms such as Listeria monocytogenes , Cryptococcus neoformans , Acanthamoeba species, or herpes simplex virus [ 34 ]. The other differential diagnoses of meningoencephalitis in the patient include leukemic meningitis, aseptic meningitis, and drug-induced meningitis (from IT therapy) [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia with e1a3 BCR-ABL1 transcript in a Nigerian with sickle cell anemia: a case report

et al. 2021

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Background The occurrence of acute leukemia in patients with sickle cell anemia is uncommon. The Philadelphia chromosome is the hallmark of chronic myeloid leukemia. However, it may also be associated with acute lymphoblastic leukemia and acute myeloblastic leukemia. The common BCR-ABL1 transcripts seen in acute lymphoblastic leukemia are e1a2, e13a2, and e14a2, while other transcripts such as e1a3, e13a3, and e6a2 occur rarely. This report describes the presentation, management, and outcome of the occurrence of B-cell acute lymphoblastic leukemia with the rare e1a3 BCR-ABL1 transcript in a patient with sickle cell anemia. Case presentation A 19-year-old male Nigerian, a known sickle cell anemia patient was admitted on account of severe vaso-occlusive crisis. Examination revealed fever, palor, and jaundice. Full blood count showed anemia and leukocytosis. Peripheral blood and bone marrow smears revealed numerous large and small lymphoblasts in keeping with the L2 subtype of acute lymphoblastic leukemia based on the French–American–British classification. Further evaluation was in keeping with a diagnosis of BCR-ABL1-positive mature B-cell acute lymphoblastic leukemia associated with the rare e1a3 transcript. He was commenced simultaneously on induction chemotherapy and Imatinib while being prepared for allogeneic stem cell transplantation. However, he died six months after diagnosis from meningoencephalitis. Conclusion The occurrence of acute lymphoblastic leukemia with a rare BCR-ABL1 e1a3 transcript in association with sickle cell anemia is uncommon and associated with poor prognosis.

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Cytarabine/methotrexate

2020

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Drug-induced aseptic meningitis in a Ph+ ALL patient with meningeal involvement

Cited by 3 publications

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Zanubrutinib-induced aseptic meningitis: a case report and literature review

Zanubrutinib-induced aseptic meningitis: a case report and literature review

Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia with e1a3 BCR-ABL1 transcript in a Nigerian with sickle cell anemia: a case report

Cytarabine/methotrexate

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