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The Incident Ocular Diseases Related to Chemotherapy in Cancer Patients are Associated with Increasing Risk of Incident Stroke
CONCLUSIONS: Incident ocular diseases related to chemotherapy were associated with a significantly higher risk of stroke.PMID:37229341 | PMC:PMC10203719 | DOI:10.6515/ACS.202305_39(3).20221005A
Source: Cancer Control - May 25, 2023 Category: Cancer & Oncology Authors: Kai-Chun Cheng Hung-Pin Tu Tsung-Hsien Lin Kai-Hung Cheng Source Type: research

Management of Primary Central Nervous System Lymphoma Using  Intra-Arterial Chemotherapy With Osmotic Blood-Brain Barrier Disruption: Retrospective Analysis of the Sherbrooke Cohort
ConclusionCIAC using HD-MTX-based protocols with OBBBD is a safe and well-tolerated procedure for the management of PCNSL. Our data suggests better PFS and survival outcomes compared to IV protocols with less hematologic toxicity and good tolerability, especially in the elderly.
Source: Frontiers in Oncology - January 20, 2021 Category: Cancer & Oncology Source Type: research

Prevalence of leukoencephalopathy and its potential cognitive sequelae in cancer patients.
In conclusion, leukoencephalopathy is well-documented for ALL patients (with a focus on methotrexate), but there is a lack of knowledge for other intravenous chemotherapeutics, other oncological populations, wider age ranges and possible risk factors (e.g. history of CNS event). Furthermore, the long-term neuropsychological impact and potential risk for neurodegenerative processes due to leukoencephalopathy remains inconclusive. Hence, large international databanks, epidemiological and prospective case-control studies are necessary to stratify risk groups for CNS-related side effects. PMID: 32799637 [PubMed - as supplied by publisher]
Source: Journal of Chemotherapy - August 19, 2020 Category: Cancer & Oncology Tags: J Chemother Source Type: research

Acute Neurotoxicity during ALL Therapy Is Associated with Treatment Intensity, Age and Female Sex - an Analysis of SAE Reports from the UKALL 2003 Trial
Discussion:This large study identifies treatment intensity as the main risk factor for developing acute neurotoxicity with female sex, age and CNS status having a significant modifying effect. CNS status may reflect increased intrathecal therapy given to non-CNS-1 patients. Females are more vulnerable to cranial radiotherapy induced neurotoxicity but this is the first report of female sex as a risk factor on contemporary chemotherapy treatment protocols. Reassuringly, the occurrence of acute neurotoxicity did not influence survival rates. These data provide an important benchmark for ongoing international deep phenotyping ...
Source: Blood - November 21, 2018 Category: Hematology Authors: Wahid, Q.-u.-A., Hamadeh, L., McGowan, S., Hough, R., Vora, A., Moorman, A. V., Halsey, C. Tags: 612. Acute Lymphoblastic Leukemia: Clinical Studies: Poster I Source Type: research

Myeloablative Conditioning with Alemtuzumab in Matched Related Donor Hematopoietic Cell Transplant for Sickle Cell Disease Prevents Graft-Versus-Host Disease without Compromising Engraftment
Conclusions:Myeloablative conditioning was well tolerated in this patient population, and the addition of alemtuzumab minimized occurrence of severe GVHD. While MDC was observed, chimerism stabilized at >50% donor cells in most patients and no graft rejection or recurrence of SCD occurred with a median follow-up of 2.9 yrs. The use of this regimen may be a promising approach to achieve low rates of GVHD while maintaining low rates of transplant related complications for patients with SCD that can tolerate myeloablative chemotherapy.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: John, T. D., Yassine, K., Naik, S., Sasa, G., Omer, B., Martinez, C. A., Tewari, P., Krance, R. A., Leung, K. S. Tags: 721. Clinical Allogeneic Transplantation: Conditioning Regimens, Engraftment, and Acute Transplant Toxicities: Poster I Source Type: research

Evaluation and Management of Acute-Onset Hemiparesis in an Adolescent With Leukemia
We present a case of a 15-year-old boy with pre-B acute lymphoblastic leukemia on chemotherapy, having recently received a high-dose methotrexate infusion in addition to intrathecal methotrexate therapy, who presented to our ED with acute right-sided hemiparesis. He was initially suspected as having a possible ischemic stroke. Magnetic resonance imaging (diffusion-weighted and fluid-attenuated inversion recovery sequence) demonstrated focal areas of diffusion restriction, an early sign of delayed-onset methotrexate neurotoxicity. Our patient received appropriate supportive care and leucovorin rescue with gradual clinical r...
Source: Pediatric Emergency Care - March 1, 2018 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Capecitabine-induced acute toxic leukoencephalopathy.
Abstract A 45-year-old woman was treated by Capecitabine (Xeloda(®)) during 6days for breast cancer with metastatic bone lesions when she presented with nausea, headaches, muscle cramps, dysarthria and swallowing disorders. A stroke was first suspected. Brain CT was normal. MRI showed bilateral and symmetric high signal intensities of deep white matter, corpus callosum and corticospinal tracts on diffusion-weighted imaging and T2 fluid-attenuated inversion recovery (FLAIR) sequence, similar to 5-FU acute leukoencephalopathy. An acute toxic leukoencephalopathy was diagnosed prompting to discontinue capecitabine, w...
Source: Neurotoxicology - May 6, 2017 Category: Neurology Authors: Obadia M, Leclercq D, Wasserman J, Galanaud D, Dormont D, Sahli-Amor M, Psimaras D, Pyatigorskaya N, Law-Ye B Tags: Neurotoxicology Source Type: research

Ntox-08. safety of intra-arterial chemotherapy in the treatment of brain tumours
The treatment of brain tumors is greatly limited the delivery impediment caused by the blood-brain barrier and blood-tumor barrier. To circumvent this limitation, different approaches have been studied, including intra-arterial delivery. Because of a significant local increase in plasma-peak concentration, this strategy increases the local area under the curve, and translates into a 3 to 5.5 fold increase in intra-tumoral chemotherapy concentration. However, intra-arterial chemotherapy in the treatment of brain tumors has a notoriously bad name, thanks to prior trials led in past decades showing significant neurotoxicities...
Source: Neuro-Oncology - November 6, 2016 Category: Cancer & Oncology Authors: Fortin, D., Caux, S., Gahide, G. Tags: NEUROTOXICITY OF THERAPY Source Type: research

Jane Cooke Wright (1919-2013): Pioneering oncologist, woman and humanitarian
Jane Wright was a fundamental researcher in cancer chemotherapy in the 1950s–1980s and was one of the first scientists to test anti-cancer drugs on humans rather than solely on mice, discovering the use of the popular antimetabolite drug methotrexate on solid tumours. From her research she was able to conclude which specific anti-cancer agents would have the greatest lethal effect on a patient’s certain cancer type and she invented a method of delivering chemotherapy agents directly to an internal cancer site. During a time when the Civil Rights in the United States of America were undergoing a transformation t...
Source: Journal of Medical Biography - February 12, 2016 Category: History of Medicine Authors: Crosby, H. L. Tags: Original Articles Source Type: research

Cervical aspergillosis with dissemination to the central nervous system: Case reports and review of the literature.
CONCLUSION: IA must be considered a possibility whenever an immunocompromised patient presents with a new brain lesion. These lesions require surgical evacuation, a procedure that allows for diagnostic confirmation and enhances prognosis. Appropriate anti-fungal therapy must be started as soon as the diagnosis is confirmed. In addition, the patient's neurological exam must be repeated and images obtained periodically to monitor treatment and detect possible recurrences. PMID: 26600985 [PubMed - as supplied by publisher]
Source: Surgical Neurology International - November 25, 2015 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Hacking The Nervous System
(Photo: © Job Boot) One nerve connects your vital organs, sensing and shaping your health. If we learn to control it, the future of medicine will be electric.When Maria Vrind, a former gymnast from Volendam in the Netherlands, found that the only way she could put her socks on in the morning was to lie on her back with her feet in the air, she had to accept that things had reached a crisis point. “I had become so stiff I couldn’t stand up,” she says. “It was a great shock because I’m such an active person.”It was 1993. Vrind was in her late 40s and working two jobs, athletics coach and a carer for disabled ...
Source: Healthy Living - The Huffington Post - May 30, 2015 Category: Consumer Health News Source Type: news

Methotrexate Encephalopathy as a Cause of Alternating Hemiplegia (P3.143)
CONCLUSIONS: Transient neurologic dysfunction with reversible MRI abnormality is a recognized consequence of intrathecal methotrexate chemotherapy in childhood ALL. Patients present with dramatic fluctuating neurologic symptoms with associated MRI changes and may be mistaken for stroke or a seizure disorder. Once the syndrome is recognized patients typically recover with supportive management and rehabilitation.Disclosure: Dr. Sullivan has nothing to disclose. Dr. Quealy has nothing to disclose. Dr. Olsevskaite has nothing to disclose. Dr. MacEneaney has nothing to disclose. Dr. Ryan has nothing to disclose. Dr. O'Toole ha...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Sullivan, C., Quealy, J., Olsevskaite, J., MacEneaney, P., Ryan, C., O'Toole, O. Tags: Neuro-oncology: CNS Lymphoma and Other Hematologic Malignancies Source Type: research

Teaching NeuroImages: Methotrexate neurotoxicity: Resolution and evolution of MRI changes within 48 hours
A 13-year-old girl presented with acute-onset right hemiparesis involving the face, arm, and leg equally. She was receiving weekly intrathecal methotrexate (last dose 6 days prior) for recently diagnosed acute lymphocytic leukemia. Brain MRI (figure 1) showed diffusion restriction in the left centrum semiovale with reduced apparent diffusion coefficient. Her hemiparesis resolved within 24 hours but 2 hours later, she developed 12-hour left hemiparesis involving face, upper limb, and dysarthria. Follow-up neurologic examination was normal. Repeat MRI (figure 2) 44 hours after the original MRI showed acute right centrum semi...
Source: Neurology - September 2, 2013 Category: Neurology Authors: Kanaan, S., Poddar, K., Ng, Y.-T. Tags: Childhood stroke, MRI, DWI, Chemotherapy-tumor, All Pediatric RESIDENT AND FELLOW SECTION Source Type: research