Drug points: Cyclosporin neurotoxicity after chemotherapy

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Abstract
Cyclosporin neurotoxicity may result from interaction with chemotherapy used for transplant conditioning 1 2 and to reverse multidrug resistance.3 We describe a case of neurotoxicity after chemotherapy for post-transplantation lymphoproliferative disease. A 9 year old boy presented with monoclonal post-transplantation lymphoproliferative disease six years after cardiac transplantation for congenital heart disease. He was taking azathioprine and cyclosporin (Neoral) 90 mg twice daily (6 mg/kg/day) with whole blood trough concentrations between 29 μg/l and 288 μg/l (Behring enzymatic assay) in the six months before diagnosis. Azathioprine treatment was discontinued, cyclosporin …