Antineoplastic treatment related leukoencephalopathy is defined as an entity in which acute or delayed changes in withe matter, secondary to chemotherapy and/or radiation, produce cerebral, cerebellar, and/or brainstem dysfunction in the absence
of
demonstrable, causally microorganism. We experienced a case of antineoplastic treatment-related leukoencepholopathy in an 115/12 year-old girl who was diagnosed as having acute lymphoblastic leukemia when she was 8 years old. She had 3 episodes
of
isolated CNS relapse during maintenance chemotherapy. One month prior to admission, she had difficulties in adaptation of new class and refused to go to school, Six days prior to admission, she began to stammer over a few words and at that night,
dysarthria became overt. Next morning, locomotor activities were slow and she was not able to walk without assistance and had right foot dragging. Brain MRI revealed diffuse demyelination in deep white matter with mild degree of diffuse
ventricular
dilatation and prominent subarachnoid space and sulcus. She had received oraniospinal irradiation(whole brain 5,040 cGy, spine 1,350 cGy), intrathecal MTX 468mg, and intrathecal Ara-C 1,890mg. Supportive managements including L-tube feeding,
steroid,
and mannitolization were done without chemotherapy under the impression of antineoplastic treatment-related leukoencephalopathy. Bone marrow relapse was detected during admission. Her general conditions deteriorated and decorticate posture
changed
to
decerebarte posture. She died at 54th hospital day but autopsy was not done.
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