Table 2.
Clinicopathological findings of two cases with autopsy-proven chemobrains
| Case 1 | Case 2 | |
|---|---|---|
| Age/Gender | 64/F | 63/M |
| Active problem | Loss of consciousness, sleep tendency, type I respiratory failure due to aspiration pneumonia and sepsis |
Disorientation, drowsy mentality, sleep tendency, coma Pneumonia, sepsis, & DIC, multiorgan failure |
| Underlying disease | Relapsed Acute undifferentiated myelogenous leukemia | Myelodysplastic syndrome excess blast 1 (MDS-EB1) |
| Chemotherapy-Regimen | FLAG, IDAC | Azacitidine #3 |
| Transplant | MUD-alloPBSCT | MUD-alloPBSCT |
| Autopsy finding |
Numerous axonal spheroid with vacuolar changes of the white matter and exogenous foamy macrophage (CD68-positive/TMEM119-negative) infiltration Beta-amyloid deposit in the degenerated axons of the optic tract of occipital and temporal lobes |
Numerous axonal spheroids with vacuolation of the white matter with exogenous foamy macrophage (CD68-positive/TMEM119-negative) infiltration Beta-amyloid deposit in the axons, extensively in the most white matter |
| Main involving area | The white matter of the occipital and temporal lobe | The white matter of the occipital, temporal, and parietal lobe |
| T- or B-lymphocytes | Absent in the entire brain parenchyma | Absent in the entire brain parenchyma |
| Survival | 3 months after alloPBSCT | 4 months after alloPBSCT (about 3 months after onset of disorientation) |
FLAG (fludarabine, Ara-Cytarabine, granulocyte colony-stimulating factor), IDAC Intermediate-dose Ara-Cytarabine, MUD Matched unrelated donor, allPBSCT Allogeneic peripheral blood stem cell transplantation