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Paraneoplastic neurological syndromes associated with lymphomas
R P Symonds1, R B Hogg, I Bone
1Beatson Oncology Centre, Western Infirmary, Glasgow, Scotland.
Leukemia & Lymphoma
|November 1, 1994
Summary
Two patients with paraneoplastic neurological syndromes experienced persistent deficits after chemotherapy-induced lymphoma shrinkage. Neurotoxic treatments require caution in these patients.
Area of Science:
- Neurology
- Oncology
- Medical Research
Background:
- Paraneoplastic neurological syndromes (PNS) are rare autoimmune disorders triggered by cancer.
- These syndromes can manifest with diverse neurological deficits, impacting quality of life.
- Chemotherapy-induced tumor regression can sometimes precede or coincide with PNS development.
Observation:
- Two patients with lymphoma (Hodgkin's and non-Hodgkin's) developed distinct neurological syndromes: brachial neuritis and cerebellar degeneration (ataxia).
- Neurological deficits emerged after significant tumor shrinkage achieved through chemotherapy.
- One patient developed L'hermitte's sign and vincristine-induced sensory neuropathy after radiation therapy to the cervical cord.
Findings:
- Both patients achieved complete remission from their respective lymphomas.
- Despite remission, there was no recovery from the established neurological deficits.
- Vincristine and radiation therapy may have exacerbated or contributed to the neurological damage.
Implications:
- This case series underscores the potential for chemotherapy and radiation to worsen pre-existing paraneoplastic neurological syndromes.
- Careful consideration of neurotoxic treatments is crucial in patients with known or suspected PNS.
- Further research is needed to elucidate the mechanisms underlying treatment-induced neurotoxicity in PNS.