Reversible posterior leukoencephalopathy during the treatment of acute lymphoblastic leukemia

Shin, Robert K.; Stern, Julie W.; Janss, Anna J.; Hunter, Jill V.; Liu, G.T.

doi:10.1212/wnl.56.3.388

Cited by 59 publications

(43 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the pediatric oncology literature, there is increasing awareness of RPLS as a complication of cancer treatment [22,24,25], particularly in the setting of hematopoietic stem cell transplantation where it is the most common severe neurological complication [8].…”

Section: Discussionmentioning

confidence: 99%

“…Neither of our patients, however, received intrathecal chemotherapy. Furthermore, in the pediatric literature there are examples of continued administration of intrathecal chemotherapy to patients who developed RPLS following initial regimens that involved intrathecal treatment, with no recurrence of neurological symptoms [24]. There is therefore little evidence of etiologic link between RPLS and intrathecal administration of cytotoxic drugs.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension is also a feature in the vast majority of RPLS reported [5,7,[9][10][11][13][14][15][16]19,21,[23][24][25][26]. In contrast to encephalopathy caused by isolated malignant hypertension, patients with RPLS often present with only moderate levels of hypertension (systolic blood pressure 130-200 mmHg, diastolic blood pressure generally > 90 mmHg); in the majority of cases this still represents a significant increase above baseline levels.…”

Section: Discussionmentioning

confidence: 99%

“…RPLS is most commonly seen in patients with hypertensive encephalopathy, eclampsia, renal failure, or use of cyclosporine or tacrolimus [13]. Despite increasing awareness of RPLS as a complication of treatment of childhood cancers [8,22,24,25], this syndrome is rarely reported in the adult oncology setting. We report two patients who developed RPLS during cytotoxic chemotherapy for hematological malignancies.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

et al. 2004

View full text Add to dashboard Cite

Reversible posterior leukoencephalopathy syndrome (RPLS) is an uncommon but distinctive clinicoradiological entity comprising of headache, seizures, visual disturbance, and altered mental function, in association with posterior cerebral white matter edema. With appropriate management, RPLS is reversible in the majority of cases. Previous reported associations of RPLS include hypertension, eclampsia, renal failure, and use of immunosuppressive drugs; reports in the adult hematology setting are rare. We report two cases of adults undergoing treatment for hematological malignancies who developed RPLS, and we emphasize the importance of early recognition and institution of appropriate management in reducing the risk of development of permanent neurological disability. Am.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Malignant disease such as Hodgkin's disease or acute lymphoblastic leukemia (ALL) is a possible disease developing RPLS (1)(2)(3)(4)(5)(6). Although the underlying pathophysiology of PRLS has been controversial, disturbed permeability of cerebral vessels may be one candidate.…”

mentioning

confidence: 99%

Reversible Posterior Leukoencephalopathy Syndrome

Abe

2004

Intern. Med.

View full text Add to dashboard Cite

Effect of therapeutic ionizing radiation on the human brain

Steen

Spence

et al. 2001

Annals of Neurology

View full text Add to dashboard Cite

We test a hypothesis that fractionated radiation therapy within a therapeutic dose range is associated with a dose-related change in normal brain, detectable by quantitative magnetic resonance imaging. A total of 33 patients were examined by quantitative magnetic resonance imaging to measure brain tissue spin-lattice relaxation time (T1) before treatment, and at various times during and after radiation therapy. A T1 map was generated at each time point, and radiation therapy isodose contours were superimposed on the corresponding segmented T1 map. Changes in white matter and gray matter T1 were analyzed as a function of radiation therapy dose and time since treatment, controlling for patient age and tumor site. In white matter, a dose level of more than 20 Gy was associated with a dose-dependent decrease in T1 over time, which became significant 6 months after treatment. There was no significant change in T1 of gray matter over time, at radiation therapy doses of less than 60 Gy. However, GM in close proximity to the tumor had a lower T1 before therapy. Our results represent the first radiation dose-response data derived from pediatric brain in vivo. These findings confirm that white matter is more vulnerable to radiation-induced change than is gray matter, and suggest that T1 mapping is sensitive to radiation-related changes over a broad dose range (20 to 60 Gy). Human white matter T1 is not sensitive to radiation therapy of less than 20 Gy, and gray matter T1 is unchanged over the dose range used to treat human brain tumor. The reduction of gray matter T1 near the tumor could result from compression of cortical parenchyma near the growing tumor mass, or from tumor cell invasion directly into the parenchyma. If brain T1 is a surrogate for radiation effect, reducing the volume of normal white matter receiving more than 20 Gy could be an important treatment planning goal.

show abstract

Reversible posterior leukoencephalopathy during the treatment of acute lymphoblastic leukemia

Cited by 59 publications

References 7 publications

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

Reversible Posterior Leukoencephalopathy Syndrome

Effect of therapeutic ionizing radiation on the human brain

Contact Info

Product

Resources

About