Acute cerebellar dysfunction with high-dose ARA-C therapy

The authors report a patient with clinical and morphologic evidence of acute cerebellar toxicity after receiving high-dose cytosine arabinoside (ARA-C) (3000 mg/m2/12 hours) for refractory AML. Damage of Purkinje cells and dentate nucleus was demonstrated. Reversible cerebellar toxicity has previously been noted in patients on an identical regimen. Signs of cerebellar dysfunction mandate immediate cessation of high-dose ARA-C therapy.