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Methotrexate intratecal

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
Michal Mego, Zuzana Sycova-Mila, Jana Obertova, Jan Rajec, Stefania Liskova, Patrik Palacka, Stefan Porsok, Jozef Mardiak
HER2-positive status is associated with increased risk of central nervous system (CNS) metastases in breast cancer patients. Leptomeningeal carcinomatosis (LMC) represents a rare but disastrous manifestation of metastatic breast cancer (MBC) with limited treatment options and poor prognosis. Several case reports of intrathecal (i.t.) trastuzumab in the treatment of LCM were published so far. Usually, i.t. trastuzumab was administered in monotherapy or in combination with metothrexate. Herein, we report for the first time two patients with metastatic breast cancer and leptomeningeal carcinomatosis treated by intrathecal methotrexate (15 mg total dose) and cytarabine (24 mg total dose) with escalating dose of trastuzumab...
October 2011: Breast: Official Journal of the European Society of Mastology
Giovanni Sanna, Maria Laura Bertolaccini, Munther A Khamashta
The involvement of the central nervous system (CNS) is one of the major causes of morbidity and mortality in systemic lupus erythematosus (SLE) patients and the less understood aspect of the disease. Its recognition and treatment continue to represent a major diagnostic and therapeutic challenge. Due to the lack of controlled randomized trials, current therapeutic approach is still empirical and based on clinical experience. The therapeutic choice depends on accurate diagnosis, identification of underlying pathogenic mechanism, severity of the presenting neuropsychiatric symptoms, and on prompt identification and management of contributing causes of CNS disease...
2008: Current Pharmaceutical Design
Adriana Vince, Snjezana Zidovec Lepej, Ivan Kurelac, Bruno Barsic, Sanja Kozic, Igor Klinar, Kamelia Zarkovic
In this report, the authors present a detailed immunological and virological assessment of an immunocompetent 17-year-old Caucasian male with a fatal Epstein-Barr virus (EBV) infectious mononucleosis presenting with meningoencephalitis and hemophagocytic syndrome. The patient with serologically confirmed EBV infectious mononucleosis was admitted to the hospital because of 3 weeks' fever. Fine-needle aspiration of lymph nodes showed reactive hyperplasia with prominent hemophagocytosis. Percentages of intracellular interferon-gamma (IFN-gamma) in CD4(+) and CD8(+) T cells in the peripheral blood progressively increased during the course of disease (10...
August 2007: Journal of Neurovirology
A Fossen
All the children, five girls and ten boys aged 8-16 years, mean 11 years, with acute lymphoblastic leukemia which had been diagnosed in 1980, 1981 or 1983 and was still in remission in 1990, were examined. The treatment included intratecal methotrexate, but no irradiation. Mean age at the time of diagnosis was 4.5 years. All the WISC-R IQ-scores were within the normal range (mean Full Scale IQ 109, range 93-142). Six children had a high negative Verbal/Performance split score (mean +/- 23, range -15 to -33)...
May 30, 1997: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
M C González-Martín, A Muñóz Villa, P García-Miguel, A Herrero Díez, T Hurtado Ruano, J L Fernández Epifanio
Long-term results in the treatment of 116 patients of acute lymphocitic leukemia with ages between six months and seven years are reported. A first group A, formed by 76 patients, was treated with prednisone and vincristine as induction protocol and maintenance therapy with 6-mercaptopurine or methotrexate. No neuromeningeal prophylaxis was made, except some cases in which intratecal methotrexate was applied. 27 patients are alive, 21 of them (27,6%) remain in complete remission for more than three years. A second group B, formed by 40 patients, was treated more recently; with an induction protocol composed by prednisone, vincristine and L-asparaginase...
June 1978: Anales Españoles de Pediatría
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