Rolf N, Boehm H, Kaindl A M, Lauterbach I, Suttorp M
University Children's Hospital, Technical University of Dresden, Germany.
Klin Padiatr. 2006 Nov-Dec;218(6):350-4. doi: 10.1055/s-2006-942276.
Severe side effects of chemotherapy in pediatric patients with acute lymphoblastic leukemia are rare, but well-known. We present two pediatric patients who developed ascending motoric paraplegia (AMP) following intrathecal chemotherapy. Both patients suffered from progressive weakness of their lower extremities, neurogenic bladder dysfunction, autonomous neural dysregulation and minor sensory deficits. Despite an initially similar clinical picture, progression and outcome were fairly different. There is convincing evidence that AMP is caused by spinal cord toxicity of intrathecally applied toxic agents such as cytarabin and/or methotrexate leading to spinal demyelinisation as demonstrated by elevated myelin basic protein in cerebrospinal fluid.
急性淋巴细胞白血病患儿化疗的严重副作用虽罕见，但广为人知。我们报告了两名接受鞘内化疗后发生上行性运动性截瘫（AMP）的儿科患者。两名患者均出现下肢进行性无力、神经源性膀胱功能障碍、自主神经调节异常以及轻微感觉障碍。尽管最初临床表现相似，但病情进展和结局却大不相同。有确凿证据表明，AMP是由鞘内应用的毒性药物如阿糖胞苷和/或甲氨蝶呤的脊髓毒性所致，导致脊髓脱髓鞘，脑脊液中髓鞘碱性蛋白升高即证明了这一点。
