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논문 기본 정보

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학술저널
저자정보
Kim, Ji-Yeon (Department of Neurosurgery, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine) Kim, Sung-Tae (Department of Radiology, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine) Nam, Do-Hyun (Department of Neurosurgery, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine) Lee, Jung-Il (Department of Neurosurgery, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine) Park, Kwan (Department of Neurosurgery, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine) Kong, Doo-Sik (Department of Neurosurgery, Center for Imaging Science, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제50권 제4호
발행연도
2011.1
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304 - 310 (7page)

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Objective : Intrathecal methotrexate (MTX) therapy combined with whole brain radiotherapy (WBRT) is one of the major treatment modalities for leukemia and lymphoma involving the central nervous system (CNS). The purpose of this study was to retrospectively determine the incidences of leukoencephalopathy and disseminated necrotizing leukoencephalopathy (DNL) following intrathecal MTX therapy for CNS lymphoma or leukemia and to assess the potential risk factors. Methods : Between January 2000 and August 2009, 143 patients with CNS lymphoma or leukemia received intrathecal MTX therapy alone or in combination with WBRT at a single institution. Patients were followed up clinically and radiologically at regular two- or three-month intervals. Medical records were reviewed to obtain information regarding the patients' demographics, medical histories, radiologic characteristics, treatments, and clinical courses. Results : On follow-up MR images, leukoencephalopathy was found in 95 of 143 patients (66.4%). The median time to develop leukoencephalopathy was 6.6 months. Among those with leukoencephalopathy, four patients showed seven extensive white-matter changes with strongly enhancing lesions demonstrating DNL. Histological confirmation was done in six lesions of three patients and radiological diagnosis alone in one patient. Four lesions spontaneously disappeared on MR images without any treatment, with a mean duration of 14 months before disappearance of DNL. Conclusion : Leukoencephalopathy is a common phenomenon that occurs following intrathecal MTX therapy; however, DNL occurs at a very low incidence. For newly developed enhancing lesions, consideration for the occurrence of DNL should be taken to avoid unnecessary invasive procedures or therapies.
#Leukoencephalopathy #Methotrexate #Intrathecal #Lymphoma #Leukemia

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참고문헌 (30)

참고문헌 신청
Antunes NL / 2002 / Methotrexate leukoencephalopathy presenting as Kluver-Bucy syndrome and uncinate seizures / Pediatr Neurol 26:305~308 google schola Batchelor T / 2003 / Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-07 / J Clin Oncol 21:1044~1049 google schola Belka C / 2001 / Radiation induced CNS toxicity--molecular and cellular mechanisms / Br J Cancer 85:1233~1239 google schola Chen CY / 1996 / Childhood leukemia : central nervous system abnormalities during and after treatment / AJNR Am J Neuroradiol 17:295~310 google schola Cossaart N / 2003 / Fatal chemotherapy- induced encephalopathy following high-dose therapy for metastatic breast cancer : a case report and review of the literature / Bone Marrow Transplant 31:57~60 google schola

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