NCMP-14. NEUROTOXICITY AFTER A SINGLE CYCLE OF INTRAVENOUS CYTARABINE

Abstract Cytarabine neurotoxicity is well-documented, typically occurring after intrathecal treatment or a cumulative systemic dose of 36 g/m2. Encephalopathy, myelopathy, and acute cerebellar syndrome have all been described, with risk factors including advanced age renal dysfunction. Here, we report case single cycle intravenous cytarabine 3 This 65 year old man history chronic kidney disease (baseline creatinine 2.0 mg/dL) primary central nervous system lymphoma had unconfirmed complete response induction therapy rituximab, methotrexate, vincristine. Methotrexate was dosed between 1 -2 g/m2 due to dysfunction delayed clearance. Given patient’s performance status comorbidities, high-dose consolidation chosen. He received intravenously on days 2 28-day cycle. On day 5, he developed truncal ataxia no longer able sit stand unsupported. then presented the emergency department 8 persistent symptoms. Vital signs showed mild hypertension without orthostatic hypotension. Neurologic exam revealed postural instability, titubation, inability maintain seated posture eyes closed. dysmetria finger-nose heel-shin testing. Blood values were notable only for an elevated 2.1 mg/dL. CT head pathology. MRI brain infarct recurrent disease. discharged home symptoms resolved by 10. clinical shortly cytarabine, diagnosed cytarabine-related neurotoxicity. Further cycles withheld close observation. While more common increased dose, it can occur Our baseline likely predisposed him. dose-reduction be considered in patients these factors.