Motor and functional outcome of myelopathy following intrathecal chemotherapy
Pedro Ferreira, Teresa Silva, Anuraj Parmanande, Susana Rosa, Jaime Pamplona.
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Intrathecal (IT) chemotherapy is a widely used treatment for hematologic tumors with central nervous system involvement. We describe a 50-year-old patient with Burkitt type acute lymphocytic leukemia who developed a neurotoxic myelopathy after IT chemotherapy with methotrexate (MTX) and cytarabine (Ara-C). This type of adverse event is rare, is usually unresponsive to pharmacologic treatment and can be potentially devastating for the patient. Although rehabilitation was effective in restoring functional independence, only partial neurological recovery was achieved. Proper classification of spinal cord injury and outcome measures are essential to assess prognosis and treatment outcome in these patients.
Key words: myelopathy, intrathecal chemotherapy, functional independence