TABLE 3.
Summary of all published cases reporting DIAM in hematological diseases.
| Reference | Sex/Age | Disease | Drugs | Administration routs | Symptoms | CSF | Brain CT/MRI | Management | Outcome | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cell count (cells/mm3) | Protein (mg/dL) | Glucose (mg/dL) | |||||||||
| Thordarson and Talstad (1986) | F/24 | ALL | Cytarabine | IV | Headache, fever, and neck stiffness | 126 | Normal | Normal | Normal | Discontinuation of cytarabine and empirical antibiotics treatment | Symptoms disappeared on the fifth day |
| Flasshove et al. (1992) | M/33 | ALL | Cytarabine | IV | Symptoms of meningitis | 6,600 | Increased | - | Normal | Discontinuation of cytarabine and broad specific antibiotics | Symptoms disappeared within 4 days |
| van den Berg et al. (2001) | F/15 | ALL | Cytarabine | IT, IV, and SC | Headache, fever, nausea, and mild nuchal rigidity | 1,200 | 200 | 19.8 | Normal | Discontinuation of cytarabine, empirical antibiotics treatment, and prevention of corticosteroids and clemastin | Symptoms disappeared |
| Pease et al. (2001) | F/8 | ALL | Cytarabine | IV | Headache, fever, photophobia, and neck stiffness | 113 | 55 | 50 | - | Discontinuation of cytarabine and empirical antibiotics treatment | Symptoms disappeared |
| Lin et al. (2009) | M/65 | CLL | Apolizumab | IV | Headache, fever, disoriented, and short-term memory deficits | 840 (92% neutrophils) | 113 | 47 | Normal | Discontinuation of apolizumab and empirical antibiotics treatment | Symptoms disappeared over a week |
| Imataki et al. (2014) | F/53 | Ph+ ALL | Dasatinib | PO | Hypersensitivity on both palms | Increased (predominance of lymphocyte) | - | - | Normal | Discontinuation of dasatinib | Symptoms disappeared |
| Vey et al. (2016) | - | AML | RG7356 | IV | - | - | - | - | - | Discontinuation of RG7356 and steroid administration | Symptoms disappeared over a week |
| - | AML | RG7356 | IV | - | - | - | - | - | Discontinuation of RG7356 and steroid administration | Symptoms disappeared over a week | |
| Reddy et al. (2018) | F/46 | MM | Daratumumab | IV | Headache, numbness in the chin, and tingling in the mouth and lips | 46 (79% neutrophils) | 24 | 89 | Normal | Discontinuation of daratumumab and Empiric antibiotic therapy | Symptoms disappeared within 4 days |
| Kako et al. (2019) | M/19 | AML | Alemtuzumab | IV | Headache and fever | Increased | - | - | - | Discontinuation of alemtuzumab and empiric antiviral therapy | Symptoms disappeared |
| F/27 | SAA | Alemtuzumab | IV | Headache and fever | Increased | - | - | - | Discontinuation of alemtuzumab and empiric antiviral therapy | Symptoms disappeared | |
| M/58 | FL | Alemtuzumab | IV | Headache and fever | Increased | - | - | - | Discontinuation of alemtuzumab and empiric antiviral therapy | Symptoms disappeared | |
| Beaumont and Suner (2020) | F/70 | Ph+ ALL | Cytarabine and methotrexate | IT | Headache | 710 (mostly neutrophils) | 28 | 72 | - | Discontinuation of IT | Symptoms disappeared within 2 weeks |
| Current report | F/33 | FL | Zanubrutinib | PO | Headache, fever, hand tremors and unsteady gait | 300 | 690 | 42.84 | meninges thickening, cistern narrowing, third ventricle and bilateral lateral ventricle enlargement and hydrocephalus, and CSF exudation | Discontinuation of zanubrutinib | Symptoms disappeared |
Abbreviations: DIAM: drug-induced aseptic meningitis; F: female; M: male; ALL: acute lymphoblastic leukemia; CLL: chronic lymphoblastic leukemia; Ph+.
ALL: Philadelphia chromosome–positive acute lymphoblastic leukemia; AML: acute myeloid leukemia; MM: multiple myeloma; SAA: severe aplastic anemia; FL: follicular lymphoma; IV: intravenous infusion; IT: intrathecal injection; SC: subcutaneous injection; PO: peros; CSF: cerebrospinal fluid; CT: computed tomography; MRI: magnetic resonance imaging.