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Intrathecal MTX

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https://www.readbyqxmd.com/read/28978582/posterior-reversible-encephalopathy-syndrome-in-a-postpartum-woman-with-acute-lymphoblastic-leukaemia-after-intrathecal-methotrexate
#1
Craig Mescher, Arne Slungaard
Posterior reversible encephalopathy syndrome (PRES) is the most common neurological complication occurring in children undergoing induction chemotherapy for acute lymphoblastic leukaemia (ALL) but is increasingly recognised to occur in adults as well. Here, we report a woman who presented with B-cell ALL (B-ALL) at the time of delivery and developed PRES 1 day after receiving intrathecal (IT) methotrexate (MTX) that rapidly resolved. She subsequently received IT MTX without recurrence of neurological symptoms...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28961838/central-nervous-system-relapse-of-diffuse-large-b-cell-lymphoma-in-the-rituximab-era-results-of-the-uk-ncri-r-chop-14-versus-21-trial
#2
M Gleeson, N Counsell, D Cunningham, N Chadwick, A Lawrie, E A Hawkes, A McMillan, K M Ardeshna, A Jack, P Smith, P Mouncey, C Pocock, J A Radford, J Davies, D Turner, A Kruger, P Johnson, J Gambell, D Linch
Background: Central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) is associated with a dismal prognosis. Here, we report an analysis of CNS relapse for patients treated within the UK NCRI phase III R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) 14 versus 21 randomised trial. Patients and methods: The R-CHOP 14 versus 21 trial compared R-CHOP administered two- versus three weekly in previously untreated patients aged ≥18 years with bulky stage I-IV DLBCL (n = 1080)...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28883219/high-dose-chemotherapy-with-autologous-stem-cell-transplantation-following-systemic-chemotherapy-prophylactic-intrathecal-methotrexate-and-radiotherapy-prevents-relapse-and-improves-the-outcome-of-advanced-stage-primary-testicular-lymphoma-even-with-cardiac
#3
Shin Lee, Takahiro Yamauchi, Keiichi Kinoshita, Shin Imamura, Kenichi Kamiya
Primary testicular lymphoma (PTL) is a rare but aggressive disease. Although most patients present in the early stage, their prognosis is poor. Similar with PTL, cardiac lymphoma is also an uncommon disease characterized by its aggressive clinical course and poor prognosis. We herein report an extremely rare case of advanced stage PTL with cardiac involvement, treated by high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) followed by systemic chemotherapy, prophylactic intrathecal methotrexate (IT-MTX), and radiotherapy...
September 6, 2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/28831736/intravascular-lymphoma-in-the-cns-options-for-treatment
#4
REVIEW
Damir Nizamutdinov, Nitesh P Patel, Jason H Huang, Ekokobe Fonkem
Purpose of review The purpose of this review was to discuss therapeutic manipulations and effective current interventions available to treat intravascular lymphoma in the central nervous system. Recent findings Patients experienced resolution and remission of disease for 14 months and up to 2 years after eight cycles of R-CHOP and four courses of intrathecal therapy with MTX, cytarabine, and prednisolone. Intravascular use of unfractionated heparin during therapy may contribute to better outcome. Summary Series of therapeutic avenues were analyzed and compared...
August 23, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28665999/analysis-of-the-role-of-intratecal-liposomal-cytarabine-in-the-prophylaxis-and-treatment-of-central-nervous-system-lymphomatosis-the-balearic-lymphoma-group-experience
#5
MULTICENTER STUDY
Marta García-Recio, Antonia Cladera, Leyre Bento, Julia Dominguez, Silvia Ruiz de Gracia, Francesca Sartori, Raquel Del Campo, Lucia García, Carmen Ballester, Jordi Gines, Joan Bargay, Antonia Sampol, Antonio Gutiérrez
Central nervous system (CNS) lymphomatosis is a fatal complication of aggressive non-Hodgkin lymphoma (NHL). In lymphoblastic or Burkitt lymphoma, without specific CNS prophylaxis the risk of CNS relapse is 20-30%. DLBCL has a lower risk of relapse (around 5%) but several factors increase its incidence. There is no consensus or trials to conclude which is the best CNS prophylaxis. Best results seem to be associated with the use of intravenous (iv) high-dose methotrexate (HDMTX) but with a significant toxicity...
2017: PloS One
https://www.readbyqxmd.com/read/28655493/eeg-with-extreme-delta-brush-in-young-female-with-methotrexate-neurotoxicity-supports-nmda-receptor-involvement
#6
Lisbeth Samsø Schmidt, Troels W Kjær, Kjeld Schmiegelow, Alfred Peter Born
Sub-acute neurotoxicity is a well-known complication to high-dose and intrathecal methotrexate (MTX) treatment of children with leukemia. Symptoms can be treated safely by dextromethorphan, a non-competitive antagonist to N-methyl-D-aspartic acid receptor (NMDAR). In a female with subacute MTX neurotoxicity, we observed an electroencephalographic (EEG) with extreme delta brush. Extreme delta brush is an EEG pattern previously described in patients with NMDAR autoimmune encephalitis. The observations suggest that the mechanism of this neurotoxicity may be mediated by the NMDAR...
September 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28654460/liposomal-cytarabine-induces-less-neurocognitive-dysfunction-than-intrathecal-methotrexate-in-an-animal-model
#7
Anna M Thomsen, Maria E Gulinello, Jing Wen, Kjeld Schmiegelow, Peter D Cole
Liposomal cytarabine is currently being tested clinically as an alternative to intrathecal (IT) methotrexate (MTX) for preventing relapse within the central nervous system among patients with acute lymphoblastic leukemia. To compare the toxicity and cognitive deficits caused by IT MTX versus liposomal cytarabine, juvenile Long Evans rats were treated with IT injections of MTX 1 mg/kg×4 doses over 8 days, or liposomal cytarabine 0.8 mg once. Mean concentrations of free cytarabine in cerebrospinal fluid remained above the cytotoxic threshold of 0...
June 26, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28500750/nausea-and-vomiting-in-children-and-adolescents-receiving-intrathecal-methotrexate-a-prospective-observational-study
#8
Jacqueline Flank, Komail Nadeem, Sheliza Moledina, Mila Khanna, Christina Schindera, Angela Punnett, L Lee Dupuis
BACKGROUND: The prevalence of nausea and vomiting after receipt of intrathecal methotrexate (IT-MTX) in pediatric oncology patients is unknown. METHODS: Patients (4-18 years) about to receive IT-MTX were eligible to participate in this prospective, observational study. Patients received antiemetics as prescribed by their clinical team. Nausea severity (patient-assessed), timing of emetic episodes, and administration of antiemetics were recorded beginning immediately prior to IT-MTX administration, for the next 24 hr (acute phase), and for a maximum of 7 additional days (delayed phase)...
October 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28338384/methotrexate-induced-neurotoxicity-in-hispanic-adolescents-with-high-risk-acute-leukemia-a-case-series
#9
Lisa Giordano, Oyinade Akinyede, Nidhi Bhatt, Dipti Dighe, Asneha Iqbal
Intrathecal methotrexate (IT MTX) and high-dose intravenous methotrexate (HD MTX) are important components of treatment in high-risk acute leukemia. We describe five Hispanic adolescents with high-risk acute leukemia at our institution who experienced MTX-induced neurotoxicity. All patients were eventually rechallenged with MTX. Two of the five patients had a second episode of neurotoxicity, but all patients recovered. Further studies should be performed to determine whether Hispanic patients are more susceptible to MTX neurotoxicity...
September 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28211579/impact-of-treatment-variability-on-survival-in-immuno-competent-and-immuno-compromised-patients-with-primary-central-nervous-lymphoma
#10
MULTICENTER STUDY
Reem Karmali, Chadi Nabhan, Adam M Petrich, Jeffrey Raizer, David Peace, Rimas Lukas, Leo I Gordon, Sanjib Basu, Vineela Chukkapalli, Parameswaran Venugopal
Patients with primary central nervous system lymphoma (PCNSL) treated in the 'real-world' setting do not represent those treated on clinical trials and might not be treated similarly. We studied characteristics and variability in care for 113 newly diagnosed PCNSL patients treated at 5 institutions in the Chicago area between 2000 and 2012. In 111 patients, single modality therapy with a high dose methotrexate (HD-MTX) regimen +/- rituximab, was most commonly employed (n = 65), and 34 underwent radiotherapy (+/- systemic therapy)...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/27942481/posterior-reversible-encephalopathy-syndrome-after-intrathecal-methotrexate-infusion-a-case-report-and-literature-update
#11
Efterpi Pavlidou, Evangelos Pavlou, Athanasia Anastasiou, Zoi Pana, Vasiliki Tsotoulidou, Maria Kinali, Emmanuel Hatzipantelis
Posterior reversible encephalopathy syndrome (PRES) is a rare clinical-radiological entity characterised by seizures, severe headache, mental status instability and visual disturbances. Hypertension is typically present. We report a case of a 13-year old boy with Burkitt lymphoma/leukaemia, who presented with posterior leukoencephalopathy 24 hours after intrathecal methotrexate (MTX) infusion. The child presented with headache, seizures, elevated blood pressure and gradual deterioration of his neurological status...
October 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27916761/can-a-p-gp-modulator-assist-in-the-control-of-methotrexate-concentrations-in-the-rat-brain-inhibitory-effects-of-rhodamine-123-a-specific-substrate-for-p-gp-on-methotrexate-excretion-from-the-rat-brain-and-its-optimal-route-of-administration
#12
Naofumi Ogushi, Kazuaki Sasaki, Minoru Shimoda
Although methotrexate (MTX) is mainly transported by reduced folate carrier, P-gp and MRP1 may also be involved in its transport. In our previous study, a potent P-gp and MRP1 modulator, Cyclosporine A, potentiated MTX concentration in rat brain. Since it is important for MTX therapy for brain tumor to clarify which transporter is dominant, we herein determined whether the specific P-gp substrate, rhodamine123 (Rho123), potentiates the transport and retention of MTX in the brain. Rho123 was injected intravenously or intrathecally into rats immediately after injection of MTX...
February 14, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/27807492/novel-brentuximab-vedotin-combination-therapies-show-promising-activity-in-highly-refractory-cd30-non-hodgkin-lymphoma-a-case-series-and-review-of-the-literature
#13
Wilfred Delacruz, Robert Setlik, Arash Hassantoufighi, Shyam Daya, Susannah Cooper, Dale Selby, Alexander Brown
Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of hematologic malignancies which typically respond to standard first-line chemoimmunotherapy regimens. Unfortunately, patients with refractory NHL face a poor prognosis and represent an unmet need for improved therapeutics. We present two cases of refractory CD30+ NHL who responded to novel brentuximab vedotin- (BV-) based regimens. The first is a patient with stage IV anaplastic large cell lymphoma (ALCL) with cranial nerve involvement who failed front-line treatment with cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP) and second line cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with high-dose methotrexate (MTX), and cytarabine (hyperCVAD) with intrathecal- (IT-) MTX and IT-cytarabine, but responded when BV was substituted for vincristine (hyperCBAD)...
2016: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/27661058/ocular-manifestation-in-myeloid-nk-cell-precursor-acute-leukemia-a-case-report-diagnosed-by-flow-cytometry-and-pcr-from-aqueous-humor
#14
Sayaka Akaike, Koju Kamoi, Mari Tezuka, Daisuke Tomizawa, Ryoichi Yoshimura, Masatoshi Takagi, Kyoko Ohno-Matsui
BACKGROUND: Myeloid/NK cell precursor acute leukemia (MNKL) is a rare type of leukemia, and ocular complications have not previously been reported. We now report a patient with MNKL who developed intraocular infiltrates during follow-up. METHODS AND RESULTS: A 13-year-old boy diagnosed with MNKL developed left eye pain 3 months after starting treatment. Examination of the left eye revealed a visual acuity of counting fingers at 20 cm, ciliary hyperemia, small corneal keratic precipitates, hypopyon, grade 4 vitreous opacities, and an obscured fundus...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27530779/treatment-of-secondary-central-nervous-system-lymphoma-with-intrathecal-rituximab-high-dose-methotrexate-and-r-dhap-followed-by-autologous-stem-cell-transplantation-results-of-the-hovon-80-phase-2-study
#15
Jeanette K Doorduijn, Gustaaf W van Imhoff, Bronno van der Holt, Harry C Schouten, Martijn R Schaafsma, Marius A MacKenzie, Joke W Baars, Marie José Kersten, Pieternella J Lugtenburg, Martin J van den Bent, Roelien H Enting, Fokje M Spoelstra, Philip Poortmans, Jacoline E C Bromberg
The prognosis of central nervous system (CNS) relapse of systemic non-Hodgkin lymphoma is poor with 1-year survival historically at 0% to 20%. Aiming to improve these results, we performed a multicenter phase 2 study in patients with a CNS relapse, with or without concurrent systemic relapse. Treatment consisted of 2 cycles of R-DHAP alternating with high-dose methotrexate (MTX) and was combined with intrathecal rituximab. Responding patients received a third R-DHAP-MTX cycle followed by busulfan and cyclophosphamide myeloablative therapy and autologous stem cell transplantation...
August 17, 2016: Hematological Oncology
https://www.readbyqxmd.com/read/27263944/treatment-of-intrathecal-methotrexate-overdose-with-folinic-acid-rescue-and-lumbar-cerebrospinal-fluid-exchange-a-report-of-two-cases
#16
Elif Kazancı, Hüseyin Gülen, Ayşe Erbay, Canan Vergin
We report two male cases (4- and 5-years-old) of intrathecal methotrexate overdose. The two boys with acute lymphoblastic leukemia were to receive intrathecal injection of methotrexate. Instead of the prescribed 12 mg, they both received a dose of 120 mg. The initial cerebrospinal fluid samples showed methotrexate concentration of 2.24x10-2M in case 1 and 1.32x10-2M in case 2. The cases were successfully treated with cerebrospinal fluid (CSF) exchange and intravenous folinic acid rescue. The favorable outcome in our cases suggests that CSF exchange is safe and that folinic acid rescue may be adequate to prevent sequelae in patients subjected to intrathecal MTX overdoses up to 120 mg...
March 5, 2011: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/27215452/-efficacy-and-security-of-intrathecal-with-methotrexate-in-the-treatment-of-meningeal-carcinomatosis
#17
Xi Wu, Junling Li, Jianping Xiao, Boyan Yang, Lei Yu, Xiaoming Wu, Jinghai Wan, Haiyan Xu, Jianxin Kong
BACKGROUND: Leptomeningeal carcinomatosis is a rare type of metastatic tumors of the central nervous system. In recent years, with the improvement of neoplasms therapies and longer survival of patients by better systemic control, incidence of leptomeningeal metastases has increased every year. However, there is still lack of effective therapies. The aim of this study is to investigate the efficacy, security and prognosis of intrathecal chemotherapy with methotrexate (MTX) in the treatment of neoplastic meningitis...
May 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27029056/treatment-of-newly-diagnosed-b-cell-origin-primary-cns-lymphoma-with-systemic-r-idaram-chemotherapy-and-intrathecal-immunochemotherapy
#18
Liren Qian, Chunhui Zhou, Jianliang Shen, Jian Cen, Wenjie Yin
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin's lymphoma (NHL). The aim was to evaluate response rate, progression free survival (PFS), overall survival (OS), and toxicity in PCNSL after systemic R-IDARAM and intrathecal immunochemotherapy with deferred radiotherapy. RESULTS: The response rate was 94% with 17 (89%) complete responses and 1 (5%) partial responses. Follow-up time is from 5 to 63 months (median, 39 months)...
May 3, 2016: Oncotarget
https://www.readbyqxmd.com/read/26984076/efficacy-of-intrathecal-mtx-ara-c-combined-with-systemic-chemotherapy-in-a-gastric-cancer-patient-with-meningeal-carcinomatosis
#19
Takahisa Yamasaki, Hirokazu Fukui, Hiroo Sei, Ken Hara, Hirotsugu Eda, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Hisatomo Ikehara, Toshihiko Tomita, Tadayuki Oshima, Jiro Watari, Hiroto Miwa
A 35-year-old man was diagnosed to have gastric cancer by endoscopic and histological examinations. Staging laparoscopy detected peritoneal metastasis. Systemic chemotherapy was started, but the patient complained of severe headache. Subsequently, a lumbar puncture demonstrated adenocarcinoma cells in the spinal fluid, suggesting the occurrence of meningeal carcinomatosis (MC) from gastric cancer. MC occurs only rarely in patients with gastric cancer, but the prognosis is invariably poor. However, this patient nevertheless survived for 12 months after receiving intrathecal MTX/Ara-C together with systemic chemotherapy...
2016: Internal Medicine
https://www.readbyqxmd.com/read/26596019/-sudden-deafness-as-the-initial-manifestation-of-chronic-myelogenous-leukemia-case-report
#20
Yandi Chen, Lifeng An, Guanghua Jin
To study the pathogenesis of hearing loss in chronic myelogenous leukemia (CML). To report one case with CML whose first sign was sudden unilateral hearing loss. Sudden hearing loss in CML was presented with dramatic high white blood cell count in peripheral blood. Some cases of sudden hearing loss in CML may be improved or even cured by leukapheresis and intrathecal chemotherapy. The proposed pathogenesis for deafness in leukemia is due to hyperleukocytosis, hyperviscosity syndrome, leukemic infiltration and the inner ear hemorrhage...
May 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
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