Severe persistent cerebellar dysfunction complicating cytosine arabinoside therapy

A case of persistent cerebellar dysfunction following high-dose cytosine arabinoside (Ara-C) treatment of acute myelogenous leukemia is reported. The symptoms developed after a cumulative dose of 24 g/m2, and 6 months after the start of symptoms, the signs of cerebellar damage were unchanged. The symptoms aggravated during a subsequent low-dose therapy with Ara-C, 15 mg twice daily. This supports the presumption that this adverse effect is caused by the cumulative dose rather than by high plasma concentrations.