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Intrathecal MTX

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https://www.readbyqxmd.com/read/29607891/effects-of-leucovorin-folinic-acid-in-the-methotrexate-treated-rat-brain
#1
Naofumi Ogushi, Kazuaki Sasaki, Minoru Shimoda
Folinic acid (FA) is generally administered to patients with CNS tumors in order to treat severe neurological disorders caused by methotrexate (MTX); therefore, we herein examined the effects of the co-administration of FA on MTX concentrations in the rat brain and cerebrospinal fluid (CSF) as well as the pharmacokinetics of MTX. MTX was intravenously or intrathecally administered to rats with or without FA. MTX concentrations were assessed by HPLC. No significant differences were observed in pharmacokinetic parameters, including kel , Vd , AUC, Cltot , and t1/2 , between the FA-treated and non-treated groups...
March 30, 2018: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29514304/brain-connectivity-and-cognitive-flexibility-in-nonirradiated-adult-survivors-of-childhood-leukemia
#2
Thibo Billiet, Iris Elens, Charlotte Sleurs, Anne Uyttebroeck, Rudi D'Hooge, Jurgen Lemiere, Sabine Deprez
Background: This study aimed to assess functional and structural brain connectivity in adult childhood leukemia survivors and the link with cognitive functioning and previously identified risk factors such as intrathecal methotrexate dose and age at start of therapy. Methods: Thirty-one nonirradiated adult childhood leukemia survivors and 35 controls underwent cognitive testing and multimodal magnetic resonance imaging (resting state functional MRI, T1-weighted, diffusion-weighted, and myelin water imaging [MWI])...
March 5, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29416652/phase-ii-study-of-rituximab-given-in-conjunction-with-standard-chemotherapy-in-primary-central-nervous-system-lymphoma-pcnsl-a-trial-of-the-ecog-acrin-cancer-research-group-e1f05
#3
Lode J Swinnen, Anne O'Neill, Philip H Imus, Sachin Gujar, David Schiff, Lawrence R Kleinberg, Ranjana H Advani, Erin M Dunbar, Dennis Moore, Stuart A Grossman
Background: Therapy of primary CNS lymphoma (PCNSL) has focused on multi-agent chemotherapy designed to cross the blood brain barrier. Rituximab has demonstrated activity in PCNSL. E1F05 is an ECOG-ACRIN multicenter phase 2 prospective trial of rituximab with high-dose methotrexate (HD-MTX)-based chemotherapy similar to the RTOG 93-10 regimen, omitting radiotherapy. Methods: Immunocompetent patients with newly diagnosed PCNSL received HD-MTX 3.5g/m2 with vincristine every two weeks for 5 doses; procarbazine for 7 days in weeks 1, 5, and 9; cytarabine 3g/m2/day IV for 2 days in weeks 11 and 14; a dexamethasone taper over 6 weeks; and rituximab 375mg/m2 IV infusion 3 times per week for weeks 1-4...
January 2, 2018: Oncotarget
https://www.readbyqxmd.com/read/29386492/-a-case-of-neurolymphomatosis-that-was-diagnosed-by-acoustic-nerve-biopsy
#4
Asuka Asanome, Kohei Kano, Kae Takahashi, Tsukasa Saito, Jun Sawada, Takayuki Katayama
A 58-year-old female was admitted to our hospital because of recurrent multiple cranial neuropathy (right facial palsy followed by involvement of the left trigeminal, facial, acoustic, pharyngeal, and vagal nerves and the right abducens nerve). Brain MRI showed gadolinium enhancement of the right abducens, bilateral facial/acoustic, and left pharyngeal/vagal nerves, and 18F-Fluorodeoxyglucose (FDG)-positron emission tomography revealed abnormal FDG uptake in the right facial, acoustic, pharyngeal, and vagal nerves and the left cervical lymph nodes...
January 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29311456/-a-survey-of-the-adverse-effects-and-influence-of-concomitant-drugs-for-methotrexate-intrathecal-administration
#5
Masanobu Uchiyama, Miho Ueno, Yasushi Takamatsu, Koichi Matsuo, Osamu Imakyure, Hidetoshi Kamimura
 In general, the intraventricular administration of cytotoxic antitumor drugs provides a high drug concentration in the cerebrospinal fluid with a reduced risk of systemic adverse reactions. Methotrexate (MTX) high-dose therapy requires close monitoring when performed in combination with trimethoprim-sulfamethoxazole (ST) therapy and proton pump inhibitor (PPI) and nonsteroidal anti-inflammatory drug administration for excretion delay and toxicity enhancement. While the frequency of systemic side effects is thought to be low with intrathecal administration, such effects do rarely but occasionally occur...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29286562/isolated-late-testicular-relapse-of-b-cell-acute-lymphoblastic-leukemia-treated-with-intensive-systemic-chemotherapy-and-response-based-testicular-radiation-a-children-s-oncology-group-study
#6
Julio C Barredo, Caroline Hastings, Xiamin Lu, Meenakshi Devidas, Yichen Chen, Daniel Armstrong, Naomi Winick, Brent Lee Wood, Rochelle Yanofsky, Mignon Loh, Julie M Gastier-Foster, Dean Thomas Jorstad, Robert Marcus, Kim Ritchey, William L Carrol, Stephen P Hunger
BACKGROUND: The incidence of isolated testicular relapse (ITR) of acute lymphoblastic leukemia (ALL) has decreased with contemporary treatment strategies, but outcomes are suboptimal with a 58% 5-year overall survival (OS). This study aimed to improve outcome in patients with ITR of B-cell ALL (B-ALL) occurring after 18 months of first clinical remission using intensive systemic chemotherapy and to decrease long-term sequelae by limiting use of testicular radiation. PROCEDURE: Forty patients in first ITR of B-ALL were enrolled...
May 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29229546/changes-in-cognition-and-dendritic-complexity-following-intrathecal-methotrexate-and-cytarabine-treatment-in-a-juvenile-murine-model
#7
Tyler C Alexander, Christy M Simecka, Frederico Kiffer, Thomas Groves, Julie Anderson, Hannah Carr, Jing Wang, Gwendolyn Carter, Antiño R Allen
Acute lymphoblastic leukemia (ALL) is the most prevalent childhood cancer and accounts for 26.8% of cancer diagnoses among children, worldwide-approximately 3000 children each year. While advancements in treating ALL have led to a remission rate of more than 90%, many survivors experience adverse neurocognitive and/or neurobehavioral effects as a result of intrathecal chemotherapy. Methotrexate (MTX) is commonly administered with cytosine arabinoside (AraC, cytarabine) during intrathecal chemotherapy for ALL...
December 8, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28978582/posterior-reversible-encephalopathy-syndrome-in-a-postpartum-woman-with-acute-lymphoblastic-leukaemia-after-intrathecal-methotrexate
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
March 2018: 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
#15
COMMENT
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
#16
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
#17
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
#18
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
#19
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
#20
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
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