Reversible Neurologic Toxicity in Patients Treated with Standard-Dose Fludarabine Phosphate for Mycosis Fungoides and Chronic Lymphocytic Leukemia

  1. Roger B. Cohen, MD;
  2. Jorge M. Abdallah, MD;
  3. James R. Gray, LCDR, MS, USNR; and
  4. Francine Foss, MD
  1. From the National Naval Medical Center and the National Cancer Institute, Bethesda, Maryland. Requests for Reprints: Roger B. Cohen, MD, NCI/Navy Medical Oncology Branch, National Naval Medical Center, Bethesda, MD 20889.

    Abstract

    Fludarabine phosphate is approved for the treatment of advanced B-cell chronic lymphocytic leukemia refractory to alkylating agents. We report two cases of disabling but reversible neurotoxicity in a patient with mycosis fungoides and a patient with chronic lymphocytic leukemia who received standard doses of fludarabine (20 to 25 mg/m2 per day for 5 days) every 28 days for 6 to 8 cycles. Serial brain magnetic resonance imaging scans in the patient with mycosis fungoides showed rapid evolution of white-matter changes with subsequent complete resolution.

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    1. Ann Intern Med January 15, 1993 vol. 118 no. 2 114-116
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