Wednesday 8 August 2012

Chemotherapy induced Acute Cerebellitis

A 60 y o male known case of oesophageal cancer not spread to other organs.
Planned to be treated with chemotherapy plus concurrent external-beam radiation therapy prior to surgery.
He received five courses of chemotherapy with carboplatin and paclitaxel. Now presented with recent onset cerebellar ataxia.
MRI study of Brain shows faint Cerebellar hyper intensity on FLAIR and Diffusion.
Imaging diagnosis: Acute Cerebellitis.
Clinical diagnosis: Chemotherapy induced Acute Cerebellitis / Cerebellar Ataxia.

Discussion: Normally, cells grow and die in a controlled way. Cancer cells keep forming without control. Chemotherapy is drug therapy that can kill these cells or stop them from multiplying. However, it can also harm healthy cells, which causes side effects. During chemotherapy there may be no side effects or just a few. The severity of side effects depend on the type and dose of chemotherapy. Common ones are nausea, vomiting, tiredness, pain and hair loss. Healthy cells usually recover after chemotherapy, so as with drug toxicity, these deficits are usually reversible unless exposure has been heavy and prolonged.

A post-marketing study of Cerebellitis (Acute cerebellar ataxia) among people who take Carboplatin. The study is created by eHealthMe based on 8 reports from FDA and user community.
Carboplatin has active ingredients of carboplatin.
It is used in cancer, lung cancer - non-small cell, chemotherapy.
Common side effects of Carboplatin include agranulocytosis, nausea, dehydration, nausea and vomiting, fever.
On Aug, 6, 2012; 26,662 people reported to have side effects when taking Carboplatin. Among them, 8 people (0.03%) have Cerebellitis.

Time on Carboplatin when people have Cerebellitis:
< 1 month           Cerebellitis 100.00%
1 - 6 months                            0.00%
6 - 12 months                          0.00%              
1 - 2 years                               0.00%
2 - 5 years                               0.00%
5 - 10 years                             0.00%
10+ years                                0.00%

Age of people (in years) who have Cerebellitis when taking Carboplatin :
0-1       Cerebellitis 0.00%
2-9                        0.00%
10-19                    0.00%
20-29                    0.00%
30-39                    0.00%
40-49                    0.00%
50-59                    0.00%
60+                     100.00%

A post-marketing study of Cerebellitis (Acute cerebellar ataxia) among people who take Paclitaxel. The study is created by eHealthMe based on 6 reports from FDA and user community.
Paclitaxel has active ingredients of paclitaxel. It is used in metastases to peritoneum, endometrial cancer, investigation abnormal, endometrial cancer stage iii, transitional cell carcinoma. Common side effects of Paclitaxel include breathing difficulty, fever, agranulocytosis, dehydration, diarrhea.
On Jul, 28, 2012: 14,867 people reported to have side effects when taking Paclitaxel. Among them, 6 people (0.04%) have Cerebellitis.

Age of people (in years) who have Cerebellitis when taking Paclitaxel
0-1      Cerebellitis 0.00%
2-9                       0.00%
10-19                   0.00%
20-29                   0.00%
30-39                   0.00%          
40-49                   0.00%
50-59                  33.33%
60+                     66.67%

References : eHealthMe - Real world drug outcomes


sanj said...

Differential will include posterior "reversible" encephalopathy in patients who have had transplants- it can be exclusively cerebellar involvement.
Important in either case to watch for raised pressure and warn the neurosurgeon that decompression my be required in selected cases as the posterior fossa is a closed space.

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