000			03006nam a22003617a 4500
008			201231s20212021 xxu||||| |||| 00| 0 eng d
022			_a2405-6502
024			_a10.1016/j.ensci.2020.100297 [doi]
024			_aPMC7750546 [pmc]
024			_aS2405-6502(20)30076-9 [pii]
040			_aOvid MEDLINE(R)
099			_a33364452
245			_aInadvertent intrathecal administration of daunomycin resulting in fatality: Case report and therapeutic considerations.
251			_aeNeurologicalSci. 22:100297, 2021 Mar.
252			_aeNeurologicalSci. 22:100297, 2021 Mar.
253			_aeNeurologicalSci
260			_c2021
260			_fFY2021
265			_sepublish
266			_d2020-12-31
520			_aBackground: Daunomycin is a chemotherapeutic agent of the anthracycline family that is administered intravenously, most commonly in combination therapy. The authors report the first known adult case of inadvertently administered daunomycin directly into the human central nervous system and the neurologic manifestations and therapeutic interventions that followed.
520			_aClinical description: A 53-year-old male presenting to the hospital for his second cycle of consolidation therapy for acute promyelocytic leukemia t(15;17) was accidentally administered 93 mg of intrathecal (IT) daunomycin. Within several hours of injection, the patient subsequently developed bilateral lower extremity pain, ascending paresthesias, headache, and left cranial nerve (CN) III palsy. Immediately following these neurologic sequalae, a subarachnoid lumbar drain was placed at the L4-5 interspace for the initial irrigation and drainage of cerebrospinal fluid (CSF). By hospital day 2, the patient's mental status significantly declined requiring an external ventricular drain (EVD) for hydrocephalus. Despite therapeutic interventions, the patient developed an ascending radiculomyeloencephalopathy with deterioration in clinical status. Eighteen days after the inadvertent injection of IT daunomycin, the patient became comatose and lost all cranial nerve function.
520			_aConclusions: Accidental IT injection of daunomycin is a neurosurgical emergency and warrants prompt intervention. Symptoms can mimic other medical conditions, making it imperative an accurate diagnosis is made so that appropriate therapies are implemented. At this time, therapies include rapid removal of the chemotherapeutic agent from the IT compartment by aspiration and irrigation; however, it is unclear if neuroprotective agents may provide added benefit. Copyright (c) 2020 The Authors.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Medical Group
656			_aNeurosurgery
657			_aCase Reports
700			_aFelbaum, Daniel R
790			_aFelbaum D, Nair MN, Patel A, Soldozy S, Spitz SM, Syed HR, Yaeger K
856			_uhttps://dx.doi.org/10.1016/j.ensci.2020.100297 _zhttps://dx.doi.org/10.1016/j.ensci.2020.100297
942			_cART _dArticle
999			_c5964 _d5964