Acute lymphoblastic leukemia (ALL) is one of the most frequent malignancies in childhood whose long-term survival has increased up to 80% thanks to modern therapy enhancements. Nevertheless, methotrexate (MTX) remains a mainstay of ALL therapy, but also represents one of the major causes of neurotoxicity in patients with ALL. MTX-induced toxicity occurs in about 9% of patients treated for ALL. It usually affects deep white matter region leading to leukoencephalopathy, which has varying clinical manifestations ranging from acute neurological disturbances to seizures or chronic permanent encephalopathy. Here we describe a 13-year-old girl affected with ALL who developed lower limbs hypesthesia and static ataxia due to transverse myelopathy after intrathecal administration of MTX therapy. A high-dose corticotherapy combined to vitamin supplementation and rehabilitation was tested. Neurological evolution was characterized by slow and partial recovery.
Departements of *Pediatrics
‡Neuropediatrics, CHU-CHR Liège, Liège, Belgium
The authors declare no conflict of interest.
Reprints: Geurten Claire, MD, Centre Hospitalier Régional de la Citadelle, Boulevard du XIIème de ligne, 1, Liege 4000, Belgium (e-mail: firstname.lastname@example.org).
Received September 2, 2018
Accepted October 23, 2018