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Indian Journal of Medical and Paediatric Oncology
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Year : 1995  |  Volume : 16  |  Issue : 3  |  Page : 177-182

Central nervous system toxicity of high dose cytosar(hdac) : report of 2 cases and review of literature.


Institute Rotary Cancer Hospital, New Delhi, India

Correspondence Address:
R Kamble
Institute Rotary Cancer Hospital, New Delhi, India

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Source of Support: None, Conflict of Interest: None


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High dose cytosine arabinoside(2-3 gm/m2 12 hourly for 8-10 doses) is often used as consolidation therapy for the management of acute myeloid leukemia(AML). Cytosine arabinoside(Ara-C) in this dose, produces significant neurotoxocity and life threatening myelotoxicity. Over the last two years, 15 patients were administered Ara-C in the dose of 1.5-2 gms/m2 12 hrly x 10 doses as post remission consolidation therapy, three(20 percent) died due to septicemia, secondary to myelotoxicity; 2(including one who died: 13 percent) developed grade II to III neurotoxicity. Neurotoxic complications of high dose Ara-C are discussed in detail. Since intermediate dose Ara-C (0.5-1.0 gms/m2 12 hrly x 8-10 doses) is found to be as effective as high dose Ara-C, such dose is recommended to avoid high morbidity and mortality related to high dose Ara-C.


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