Severe cerebral toxicity after intravenous nitrogen mustard therapy

Bethlenfalvay, Nicholas C.; Bergin, James J.

doi:10.1002/1097-0142(197202)29:2<366::aid-cncr2820290216>3.0.co;2-l

Cited by 18 publications

(4 citation statements)

References 10 publications

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“…Mechlorethamine is rarely neurotoxic, but encephalopathy and hearing loss have been reported after standard infusion [66, 67]. Vincristine is the most neurotoxic vinca alkaloid; it causes a dose limiting mixed motor-sensory neuropathy in the majority of patients [68].…”

Section: Neurologic Complications Of Hl Treatmentmentioning

confidence: 99%

Hodgkin's Lymphoma: A Review of Neurologic Complications

Grimm

Chamberlain

2011

Advances in Hematology

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Hodgkin's lymphoma is a hematolymphoid neoplasm, primarily of B cell lineage, that has unique histologic, immunophenotypic, and clinical features. Neurologic complications of Hodgkin's Lymphoma can be separated into those that result directly from the disease, indirectly from the disease, or from its treatment. Direct neurologic dysfunction from Hodgkin's Lymphoma results from metastatic intracranial spinal disease, epidural metastases causing spinal cord/cauda equina compression, leptomeningeal metastases, or intradural intramedullary spinal cord metastases. Indirect neurologic dysfunction may be caused by paraneoplastic disorders (such as paraneoplastic cerebellar degeneration or limbic encephalitis) and primary angiitis of the central nervous system. Hodgkin's lymphoma treatment typically includes chemotherapy or radiotherapy with potential treatment-related complications affecting the nervous system. Neurologic complications resulting from mantle-field radiotherapy include the “dropped head syndrome,” acute brachial plexopathy, and transient ischemic attacks/cerebral infarcts. Chemotherapy for Hodgkin's lymphoma may cause cerebral infarction (due to emboli from anthracycline-induced cardiomyopathy) and peripheral neuropathy.

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Section: Neurologic Complications Of Hl Treatmentmentioning

confidence: 99%

Hodgkin's Lymphoma: A Review of Neurologic Complications

Grimm

Chamberlain

2011

Advances in Hematology

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“…Although brain damage secondary to hypoxia may contribute, there is clear evidence from the therapeutic use of nitrogen mustard or mechlorethamine that this agent causes clinically significant neuronal degeneration in the absence of hypoxia when administered into the bloodstream of cancer patients. [19][20][21][22] In non-nervous tissue, mustards interfere with glycolysis, antioxidant enzyme levels and glutathione levels, but these biochemical changes are S36 G. E. KISBY ET AL. considered secondary to its direct damage to DNA.…”

Section: Introductionmentioning

confidence: 99%

In vitro neurotoxic and DNA-damaging properties of nitrogen mustard

Kisby¹,

Springer²,

Spencer³

2001

J. Appl. Toxicol.

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“…Drug-induced seizures have occasionally been reported following the administration of mechlorethamine (Bethlenfalvay & Bergin 1972;Sullivan et al 1982). Conversely, cyclophosphamide has not been reported as causing convulsions.…”

Section: Alkylating Agentsmentioning

confidence: 99%

Clinical Features, Pathogenesis and Management of Drug-Induced Seizures

1990

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Many classes of pharmacological agents have been implicated in cases of drug-induced seizures. The list includes antidepressant drugs, lithium salts, neuroleptics, antihistamines (H1-receptor antagonists), anticonvulsants, central nervous system stimulants, general and local anaesthetics, antiarrhythmic drugs, narcotic and non-narcotic analgesics, non-steroidal anti-inflammatory drugs, antimicrobial agents, antifungal agents, antimalarial drugs, antineoplastic drugs, immunosuppressive drugs, radiological contrast agents and vaccines. For each of these classes of drugs, this article offers a revision of the literature and emphasises in particular the frequency of the adverse reaction, its clinical presentation, its presumed epileptogenic mechanism and the therapeutic strategy for the management of drug-induced seizures. An attempt is also made to distinguish seizures induced by standard dosages from those provoked by accidental or self-induced intoxication. For some classes of drugs such as antidepressants, neuroleptics, central nervous system stimulants (e.g. theophylline, cocaine, amphetamines) and beta-lactam antibiotics, seizures are a well recognised adverse reaction, and a large body of literature has been published discussing exhaustively the major aspects of the issue; sufficient data are available also for the other classes of pharmacological agents mentioned above. In contrast, several other drugs [e.g. allopurinol, digoxin, cimetidine, protirelin (thyrotrophin releasing hormone), bromocriptine, domperidone, insulin, fenformin, penicillamine, probenecid, verapamil, methyldopa] have not been studied thoroughly under this aspect, and the only source of information is the occasional case report. This review does not address the issue of seizures induced by drug withdrawal.

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Severe cerebral toxicity after intravenous nitrogen mustard therapy

Cited by 18 publications

References 10 publications

Hodgkin's Lymphoma: A Review of Neurologic Complications

Hodgkin's Lymphoma: A Review of Neurologic Complications

In vitro neurotoxic and DNA-damaging properties of nitrogen mustard

Clinical Features, Pathogenesis and Management of Drug-Induced Seizures

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