ClinicaI Reversible Myelopathy in T-Cell Lymphoblastic Lymphoma Treated with Nelarabine and Radiotherapy: Report of a Case and Review of Literature of an Increasing Complication

Maria Chiara Tisi, Giuseppe Ausoni, Maria Gabriella Vita, Tommaso Tartaglione, Mario Balducci, Luca Laurenti, Patrizia Chiusolo, Stefan Hohaus, Simona Sica
  • Maria Chiara Tisi
    Institute of Hematology, Catholic University S. Cuore, Rome, Italy |
  • Giuseppe Ausoni
    Institute of Hematology, Catholic University S. Cuore, Rome,
  • Maria Gabriella Vita
    Institute of Neurology, Catholic University S. Cuore, Rome,
  • Tommaso Tartaglione
    Institute of Radiology, Catholic University S. Cuore, Rome,
  • Mario Balducci
    Institute of Radiation Oncology, Catholic University S. Cuore, Rome,
  • Luca Laurenti
    Institute of Hematology, Catholic University S. Cuore, Rome,
  • Patrizia Chiusolo
    Institute of Hematology, Catholic University S. Cuore, Rome,
  • Stefan Hohaus
    Institute of Hematology, Catholic University S. Cuore, Rome,
  • Simona Sica,


To date, eleven cases of irreversible neurological defects in T- ALL patients treated with nelarabine have been described in the last 4 years, seven of these after stem cell transplantation (SCT) for T Lymphoblastic Lymphoma (T-LBL). Most of patients had an unfavorable outcome or irreversible damage.

We report the case of a 41-year-old woman suffering from T-LBL who presented severe but reversible myelopathy after nelarabine based treatment and mediastinum radiotherapy, and we perform a review of literature.


T Lymphoblastic Lymphoma, Nelarabine, Myelopathy

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Submitted: 2014-11-22 10:40:37
Published: 2015-02-17 00:00:00
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Hoelzer D, Gökbuget N, Digel W, Faak T, Kneba M, Reutzel R, Romejko-Jarosinska J, Zwolinski J, Walewski J. Outcome of adult patients with T-lymphoblastic lymphoma treated according to protocols for acute lymphoblastic leukemia. Blood 2002 ;99:4379-85.

Cheson BD. Role of functional imaging in the management of lymphoma. J Clin Oncol 2011 ;29:1844-54.

Common terminology criteria for Adverse Events (CTCAE); v4.03: June 14, 2010. National Institute of Health; National Cancer Institute.

Reilly KM, Kisor DF. Profile of nelarabine: use in the treatment of T-cell acute lymphoblastic leukemia. Onco Targets Ther 2009 ; 2:219-28.

Papayannidis C, Iacobucci I, Abbenante MC, Curti A, Paolini S, Parisi S, Baccarani M, Martinelli G. Complete paraplegia after nelarabine treatment in a T-cell acute lymphoblastic leukemia adult patient. Am J Hematol 2010 ;85: 608.

Forcade E, Leguay T, Vey N, Baruchel A, Delaunay J, Robin M, Socié G, Dombret H, Peffault de Latour R, Raffoux E. Nelarabine for T cell acute lymphoblastic leukemia relapsing after allogeneic hematopoietic stem cell transplantation: an opportunity to improve survival. Biol Blood Marrow Transplant 2013 ;19: 1124-6.

Kawakami M, Taniguchi K, Yoshihara S, Ishii S, Kaida K, Ikegame K, Okada M, Watanabe S, Nishina T, Hamada H, Nakagawa M, Ogawa H. Irreversible neurological defects in the lower extremities after haploidentical stem cell transplantation: possible association with nelarabine. Am J Hematol 2013 ; 88: 853-7.

Gollard RP, Selco S. Irreversible myelopathy associated with nelaribine in T-cell acute lymphoblastic leukemia. J Clin Oncol 2013 ;31:327-31.

Hartz B, Löbel U, Hagel C, Escherich G. Fatal neurological side-effects with necrosis of spinal cord following nelarabine treatment in a child with relapsed T-cell acute lymphoblastic leukemia. Am J Hematol 2013 ;88:1096-7.

Ngo D, Patel S, Kim EJ, Brar R, Koontz MZ. Nelarabine neurotoxicity with concurrent intrathecal chemotherapy: Case report and review of literature. J Oncol Pharm Practic 2014 ;0:1–5.

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