Central nervous system toxicity of fludarabine phosphate.
Central nervous system toxicity of fludarabine phosphate.
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磷酸氟达拉滨的中枢神经系统毒性。
DOI：
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
Hoth Df
中科院分区：
文献类型：
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作者：
Chun Hg;Leyland;Caryk Sm;Hoth Df
：14名患者在接受研究中的抗肿瘤药物磷酸氟达拉滨(FAMP)后出现严重的中枢神经系统(CNS)毒性。中枢神经系统毒性具有起病晚、病程进展快的特点。视力障碍是最常见的表现症状，在大多数情况下最终发展。还观察到精神状态恶化和进行性脑病。临床中枢神经系统毒性的发展与剂量有关，36例大剂量(大于或等于96 mg/m2/d，疗程5~7天)的患者中13例(36.1%)出现神经毒性，而443例小剂量(小于或等于125 mg/m2/疗程)患者中仅1例(0.2%)出现类似的毒性。尽管这种毒性的确切机制尚不清楚，但渐进性脱髓鞘似乎是负责任的过程。对临床数据的广泛回顾未能确定可能导致中枢神经系统毒性发展的因素。接受FAMP试验的患者应仔细监测可能出现的神经毒性。
: Fourteen patients developed severe central nervous system (CNS) toxicity after receiving an investigational antitumor agent, fludarabine phosphate (FAMP). The CNS toxicity has the distinctive features of delayed onset and progressive clinical course. Visual deficits were the most common presenting symptom and developed eventually in most cases. Deterioration of mental status and progressive encephalopathy were also observed. The development of clinical CNS toxicity appears dose-related; thirteen of 36 patients (36.1%) who received FAMP at high doses (greater than or equal to 96 mg/m2/day for 5-7 days per course) developed neurotoxicity, while only one of 443 patients (0.2%) who received the drug at low doses (less than or equal to 125 mg/m2 per course) developed similar toxicity. Although the precise mechanism responsible for this toxicity is yet unknown, progressive demyelination appears to be the responsible process. Extensive review of the clinical data failed to identify factors which might contribute to the development of CNS toxicity. Patients on trials of FAMP should be meticulously monitored for the possible development of neurotoxicity.