Complications of Chemotherapy

Abstract

A 2-year-old previously healthy girl presented to hospital because of irritability, fatigue, pallor and lower extremity weakness. Acute lymphoblastic leukemia (non-T non-B type) was diagnosed by peripheral blood smear and bone marrow aspirate. Chemotherapy was given and included vincristine, prednisone, L-asparaginase and intrathecal methotrexate. In addition, blood and platelet transfusions were given as appropriate. A lumbar puncture showed no cells, glucose 2.7 mmol/L (normal 2.2 – 4.4 mmol/L), protein of 0.40 (normal 0.150 – 0.450 g/L). A routine chest x-ray had shown probable spinal column anomalies subsequently confirmed on thoraco-lumbar views as splitting of the T10 and T11 vertebra with anterior fusion. Other examiners failed to demonstrate leg weakness and at discharge (5 weeks later) the child was walking normally. © 1985, Canadian Neurological Sciences Federation. All rights reserved.