Multifocal leukoencephalopathy associated with 5-fluorouracil and levamisole adjuvant therapy for colon cancer. A report of two cases and review of the literature. The INTACC. Intergruppo Nazionale Terpia Adiuvante Colon Carcinoma

Ann Oncol. 1996 Apr;7(4):412-5. doi: 10.1093/oxfordjournals.annonc.a010610.

Abstract

Background: Since 1990 the combination of 5-fluorouracil plus levamisole has been considered the standard therapy for stage B2-C resected colon cancer in the adjuvant setting. Since 1992, 14 cases of multifocal leukoencefalopathy following 5-fluorouracil and levamisole therapy have been reported.

Patients and methods: Two cases of this rare but severe neurological syndrome, observed at our Institution within the scope of the INTACC (Intergruppo Nazionale Terapia Adiuvante Colon Carcinoma, Italy) 01 study, are described.

Conclusions: The clinical and radiological features of the syndrome and the relationships between therapy (with the possible pivotal role played by levamisole) and onset of the multifocal leukoencephalopathy are analyzed in light of the literature data.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Chemotherapy, Adjuvant
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / surgery
  • Female
  • Fluorouracil / therapeutic use*
  • Humans
  • Leukoencephalopathy, Progressive Multifocal / chemically induced*
  • Levamisole / therapeutic use*
  • Middle Aged

Substances

  • Levamisole
  • Fluorouracil