Cytarabine-induced Cerebellar Toxicity in a Young Patient with B-cell ALL: A Case Report

Background: Acute cerebellar toxicity following high-dose cytarabine treatment is a well-documented but rare complication. Symptoms can progress if therapy continues even after the initial onset of deficits hence, prompt recognition and termination of treatment is essential. Methods: We report a case of a 20-year-old Filipino male with B-cell acute lymphoblastic leukemia (ALL) in relapse, with leptomeningeal spread, presenting with impaired saccades and pursuits, scanning speech, head titubation, limb and truncal ataxia after chemotherapy with high dose cytarabine. The patient was treated with intravenous dexamethasone with resolution of cerebellar deficits. Results and Conclusion: Certain risk factors are speculated to predispose patients to cerebellar toxicity however, no single factor has been proven to be an absolute determinant. Our case highlights central nervous system disease as a risk factor for cytarabine-induced cerebellar degeneration.