Duru F, Ertem U, Dagdemir A, Kunak B, Keskin T, Saatci I, Gündogdu S, Cila A
Dr. Sami Ulus Children's Hospital Department of Pediatric Oncology and Neurology, Ankara, Turkey.
Leuk Lymphoma. 1997 Jul;26(3-4):377-85. doi: 10.3109/10428199709051788.
A nine-year old girl with T cell acute lymphoblastic leukemia (ALL) had acute severe neurologic complications at the end of the remission-induction chemotherapy course. Thirty-six hours following triple intrathecal (IT) therapy and intravenous (IV) administration of L-asparaginase (L-asp), tetraplegia developed and she became unconscious. She had bouts of hypertension and persistent tachycardia unresponsive to digitalis therapy. Magnetic resonance imaging (MRI) showed multiple brain white matter hyperintensities and filling defects in the saggital sinus, suggesting thrombosis. Over the 40 days, in addition to her neurologic compromise she also had transient diabetes mellitus, severe hyperlipidemia, hypoproteinemia and edema, liver and heart failure and staphylococcus aureus sepsis with prolonged bone marrow depression. Despite, coexistence of all these chemotherapy related complications, her neurologic functions and multiple organ failure improved gradually. After a 70 days' period of interruption, chemotherapy was resumed and continued without any further complications. Although, the etiology of her extensive sensitivity to some drugs remains unclear, we believe that it is important to document these unusual events in this child.
一名患有T细胞急性淋巴细胞白血病（ALL）的9岁女孩在缓解诱导化疗疗程结束时出现了急性严重神经并发症。在三联鞘内注射（IT）治疗和静脉注射（IV）L-天冬酰胺酶（L-asp）36小时后，出现四肢瘫痪并昏迷。她有高血压发作和持续性心动过速，对洋地黄治疗无反应。磁共振成像（MRI）显示多个脑白质高信号和矢状窦充盈缺损，提示血栓形成。在40天内，除了神经功能损害外，她还出现了短暂性糖尿病、严重高脂血症、低蛋白血症和水肿、肝和心力衰竭以及金黄色葡萄球菌败血症，并伴有长期骨髓抑制。尽管存在所有这些与化疗相关的并发症，但她的神经功能和多器官功能衰竭逐渐改善。在中断70天后，恢复化疗并持续进行，未出现任何进一步的并发症。虽然她对某些药物广泛敏感的病因尚不清楚，但我们认为记录这个孩子的这些异常事件很重要。
