REVERSIBLE MRI LESIONS DUE TO PEGASPARGASE TREATMENT OF NON-HODGKINS-LYMPHOMA

L-Asparaginase is the major induction-phase agent for treatment of acu te lymphoblastic leukemia (ALL) and an important adjuvant in treatment of non-Hodgkin's lymphoma (NHL), However, L-asparaginase-induced dist urbances of clotting homeostasis may result in thrombosis or hemorrhag e, Thrombotic occlusion of small cerebral veins has been reported in p atients with ALL treated with this agent, but have not been described in NHL patients or those treated with the long-acting synthetic congen er, pegaspargase, We report a 16-year-old boy with NHL who developed a focal motor seizure 15 min after receiving intravenous pegaspargase, MRI of the brain demonstrated multiple cortical and subcortical lesion s that most likely represented focal brain edema due to thrombotic ven ous occlusion, which improved remarkably within 3 days and completely resolved within 3 weeks without specific intervention or permanent cli nical consequences, This process must be considered when such changes are detected in NHL patients. (C) 1997 by Elsevier Science Inc. All ri ghts reserved.