Cytarabine-induced peripheral neuropathy in a young patient with acute myeloid leukemia: a case report

Introduction and Importance: Cytarabine, a pyrimidine analog, is commonly used to treat multiple hematological conditions, such as acute leukemias and lymphomas. One of the rare and less reported complications of cytarabine is peripheral neuropathy, in which peripheral nerves are damaged, often causing weakness, numbness, and pain, usually in the hands and feet. Case Presentation: We report the case of a 17-year-old male who developed a gradual onset of weakness and sensory loss in all four limbs during treatment with conventional dose of cytarabine for acute myeloid leukemia. Cytarabine was discontinued after the development of symptoms, and his motor and sensory functions gradually improved over the course of three months. Clinical Discussion: Alongside some well-known side effects of cytarabine including bone marrow suppression, cerebellar syndrome, and cardiotoxicity, peripheral neuropathy is one of the uncommon side effects of cytarabine. Diagnosis includes identifying and grading the severity of chemotherapy-induced peripheral neuropathy (CIPN) through clinical assessment and nerve conduction studies. Management includes withdrawing the chemotherapeutic agent, supportive treatment with drugs such as duloxetine. Recent studies also favor the use of acupuncture and sensorimotor-based exercise intervention for the management of CIPN. Methods: This case report has been prepared in line with the SCARE 2023 Criteria. 15 Conclusion: Although rare, even conventional dosage of cytarabine can cause peripheral neuropathy, and routine neuromuscular examinations can help in the early diagnosis and intervention to limit further progression and reverse the course of the disease.