Radiation myelitis following allogeneic stem cell transplantation and consolidation radiotherapy for non-Hodgkin's lymphoma

David Schwartz, G. P. Schechter, S. Seltzer, T. R. Chauncey

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Myelitis is a rare but well documented complication of therapeutic radiation exposure to the spinal cord and is characterized by delayed development of paresthesias, sensory changes and, in severe cases, progressive paresis and paralysis. Although accepted radiation tolerance limits for the spinal cord have successfully limited the incidence of this problem (45-50 Gy, in daily 1.8-2 Gy fractions), aggressive systemic therapy may render patients more susceptible to radiation-related neurotoxicity. We describe the case of a 38-year-old man with refractory non-Hodgkin's lymphoma who underwent matched sibling peripheral blood stem cell transplant following a conditioning regimen of cyclosphosphamide (60 mg/kg × 2) and total body irradiation (120 cGy × 11). This was followed by delivery of 30.6 Gy involved-field radiation at 1.8 Gy/day to the mediastinum and left supraclavicular fossa for bulky residual tumor. Although maximum cumulative radiation dose to the spinal cord was less than 45 Gy, the patient subsequently developed progressive lower extremity weakness and MRI abnormalities of the spinal cord limited to the radiation field. This represents the second report in the literature of this unexpected complication, prompting a need to reexamine current guidelines for radiotherapy in the context of high-dose systemic treatment.

Original languageEnglish (US)
Pages (from-to)1355-1359
Number of pages5
JournalBone Marrow Transplantation
Volume26
Issue number12
DOIs
StatePublished - Dec 1 2000

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Myelitis
Stem Cell Transplantation
Non-Hodgkin's Lymphoma
Spinal Cord
Radiotherapy
Radiation
Paresthesia
Whole-Body Irradiation
Radiation Tolerance
Residual Neoplasm
Mediastinum
Paresis
Paralysis
Siblings
Lower Extremity
Therapeutics
Guidelines
Transplants
Incidence

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Radiation myelitis following allogeneic stem cell transplantation and consolidation radiotherapy for non-Hodgkin's lymphoma. / Schwartz, David; Schechter, G. P.; Seltzer, S.; Chauncey, T. R.

In: Bone Marrow Transplantation, Vol. 26, No. 12, 01.12.2000, p. 1355-1359.

Research output: Contribution to journalArticle

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