Cerebellar toxicity during cytarabine therapy associated with renal insufficiency

Acute cerebellar toxicity with ataxia and dysarthria is a well-known side effect during high-dose cytarabine therapy. Dose, age, previous neurological disorders, hepatic dysfunction, and renal insufficiency have been inconsistently reported as risk factors. The present paper presents a patient with renal insufficiency who developed severe cerebellar toxicity following treatment with a dose of cytarabine (8 g/m2 over 5 days) not generally expected to be associated with neurotoxicity. Together with a review of the literature, the present case gives evidence of renal insufficiency as a major risk factor in the development of cerebellar toxicity during cytarabine therapy. Reduced doses of cytarabine should be considered in patients with renal impairment.