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Central and peripheral myelinopathy associated with systemic neoplasia and chemotherapy
Author(s) -
Mena Hernando,
Garcia Julio H.,
Velandia Fernando
Publication year - 1981
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19811015)48:8<1724::aid-cncr2820480807>3.0.co;2-u
Subject(s) - medicine , gliosis , myelin , pathology , chemotherapy , lesion , radiation therapy , infiltration (hvac) , central nervous system , surgery , physics , thermodynamics
Three adult patients with leukemia and a patient with cutaneous melanoma were treated with a variety of therapeutic agents administered systemically. Three of these patients received either cytosine arabinoside or thio‐TEPA, by intrathecal injection and radiotherapy to the cranium or spine. Three patients developed progressive motor and sensory deficits and the fourth became confused and disoriented. These symptoms were chronologically related to the time when chemotherapy was begun. Death occurred 11/2, 2, 5 and 7 months, respectively, after the beginning of neurologic deficit. The spinal white matter showed vacuolation, myelin disintegration, axonal swelling, fibrillary gliosis, and infiltration by macrophages. Vesicular disintegration of the myelin lamellae seems to be the earliest lesion affecting both central and peripheral myelin. Gliosis and macrophages were visible only in the two patients who survived at least five months from the time of the neurologic deficit.