Related Experiment Video
Updated: Jun 26, 2026
Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma
Published on: October 27, 2014
Reversible posterior leukoencephalopathy syndrome in a child treated with bevacizumab
Carolyn Fein Levy1, Khine Zin Oo, Fernando Fireman
1Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York, USA.
Insights
Bevacizumab, a VEGF inhibitor, can cause reversible posterior leukoencephalopathy syndrome (RPLS). This rare side effect, presenting as hypertension and seizures, resolved in a pediatric hepatoblastoma patient with prompt blood pressure management.
Area of Science:
- Oncology
- Neurology
- Pharmacology
Background:
- Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor (VEGF).
- Hypertension is a known side effect of VEGF inhibitors.
- Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare but serious adverse event associated with bevacizumab.
Observation:
- A 6-year-old child with refractory hepatoblastoma was treated with bevacizumab, gemcitabine, and oxaliplatin.
- The patient experienced a hypertensive crisis, seizures, and MRI findings indicative of RPLS.
- These symptoms emerged during the course of bevacizumab therapy.
Findings:
- The clinical presentation and MRI findings were consistent with RPLS.
- The patient's condition completely resolved without any lasting neurological deficits.
- Stringent blood pressure control was the key factor in the patient's recovery.
Implications:
- This case highlights the risk of RPLS in pediatric patients receiving bevacizumab.
- Early recognition and aggressive management of hypertension are crucial for preventing neurological sequelae.
- As bevacizumab use expands in pediatric oncology, increased awareness and vigilance for RPLS are necessary.
Abstract:
Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor (VEGF). Hypertension is a well-recognized, common side effect of VEGF blocking agents. The reversible posterior leukoencephalopathy syndrome (RPLS) has been described as a rare but serious consequence of bevacizumab administration. We present a case of a 6-year-old child with refractory hepatoblastoma who developed hypertensive crisis, seizures and MRI changes consistent with RPLS while receiving bevacizumab with gemcitabine and oxaliplatin. Findings completely resolved without neurologic sequelae with stringent blood-pressure control. Better understanding of risk for RPLS, prompt recognition and aggressive management will be required as bevacizumab gains wider use in pediatrics.
