Nelarabine-Induced Myelotoxicity

A 29-year-old woman with relapsed T-cell acute lymphoblastic leukemia presented with 4 months of progressive ataxia, weakness, and bowel/bladder incontinence. Symptoms started after completing 2 cycles of nelarabine. Examination revealed paraplegia and complete sensory loss from mid-chest down, loss of vibration and joint position in upper limbs, areflexia, and bilateral Babinski signs. EMG showed fibrillation potentials with no activated motor...