Brain damage after intrathecal methotrexate.

Brain damage after intrathecal methotrexate.

Ten brains from leukaemic patients given intrathecal methotrexate and 10 from leukaemic patients without intrathecal therapy have been examined. Three of the methodtrexate treated patients appear to have died from their therapy. The histological changes consisted of destruction of oligodendrocytes, sometimes complete over large areas, and sometimes relatively slight. All the patients who surviv...

Accidental intrathecal methotrexate overdose.

Prevention of neurotoxicity by high-dose folinic acid rescue after high-dose methotrexate and intrathecal methotrexate without compromising cure inspite of previous transient leukoencephalopathy after intrathecal methotrexate.

Dear Editor, Methotrexate (MTX) is a frequently used chemotherapeutic agent in the treatment of childhood acute lymphoblastic leukaemia (ALL) and lymphoma. Besides oral and intravenous MTX, intrathecal MTX is an essential component of chemotherapy for ALL and is effective in preventing recurrences of central nervous system (CNS) leukaemia. Acute, subacute and chronic neurotoxicity have been obs...

Methotrexate myelopathy after intrathecal chemotherapy: a case report

INTRODUCTION Methotrexate is often administered intrathecally or into the cerebral ventricles, particularly in patients with central nervous system tumors. However, in addition to chemical arachnoiditis, methotrexate can induce severe myelopathy. CASE PRESENTATION A 59-year-old Japanese man with diffuse B-cell lymphoma who underwent systemic chemotherapy including methotrexate and 20 Gy of ra...

Re: Treatment of accidental intrathecal methotrexate overdose.

Widemann et al. (1) presented data on the use of cerebrospinal fl uid (CSF) exchange to remove methotrexate before carboxypeptidase G 2 (CPDG 2) administration among patients who had an accidental intrathecal methotrexate overdose. They reported that CSF drainage removed 32% – 58% of the methotrexate dose. Although they showed the percent decreases in CSF methotrexate concentration before and a...