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high dose methotrexate

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https://www.readbyqxmd.com/read/28338384/methotrexate-induced-neurotoxicity-in-hispanic-adolescents-with-high-risk-acute-leukemia-a-case-series
#1
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...
March 24, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28331101/immunotherapy-of-nivolumab-with-dendritic-cell-vaccination-is-effective-against-intractable-recurrent-primary-central-nervous-system-lymphoma-a-case-report
#2
Motomasa Furuse, Naosuke Nonoguchi, Naoki Omura, Mitsuaki Shirahata, Koichi Iwasaki, Toshio Inui, Toshihiko Kuroiwa, Hiroko Kuwabara, Shin-Ichi Miyatake
We report effective treatment with nivolumab of a patient with recurrent primary central nervous system lymphoma (PCNSL) after multiple therapies. A 41-year-old woman with a right parietal PCNSL underwent treatment with high-dose methotrexate and radiotherapy. After recurrence in the left frontal lobe, the patient received several chemotherapies, including methotrexate and rituximab, and underwent surgery. The tumor was refractory to these treatments, and the patient then underwent intensity-modulated radiotherapy (IMRT)...
March 23, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28322936/the-impact-of-liposomal-formulations-on-the-release-and-brain-delivery-of-methotrexate-a-in-vivo-microdialysis-study
#3
Yang Hu, Jaap Rip, Pieter J Gaillard, Elizabeth de Lange, Margareta Hammarlund-Udenaes
The impact of liposomal formulations on the in vivo release and brain delivery of methotrexate (MTX) was quantitatively assessed in rats. Two PEGylated liposomal MTX formulations based on hydrogenated soy phosphatidylcholine (HSPC) or egg-yolk phosphatidylcholine (EYPC) were prepared. The drug release and uptake into the brain after intravenous administration of both formulations were compared with unformulated MTX by determining the released, unbound MTX in brain and plasma using microdialysis. Total MTX concentrations in plasma were determined using regular blood sampling...
March 17, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28315229/primary-central-nervous-system-lymphoma-essential-points-in-diagnosis-and-management
#4
REVIEW
Semra Paydas
Primary central nervous system lymphoma (PCNSL) is an extra-nodal non-Hodgkin lymphoma. PCNSL is defined as lymphoma involving the brain, leptomeninges, eyes, or spinal cord without evidence of lymphoma outside the CNS. Treatment includes induction with chemotherapy and consolidation with whole-brain radiotherapy or high-dose chemotherapy supported by autologous stem cell transplantation. High-dose methotrexate is the most important drug in cases with PCNSL, and this drug will be used in combination with small molecules, BTK inhibitors, new monoclonal antibodies, and checkpoint blockers...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28288894/endogenous-inspired-biomineral-installed-hyaluronan-nanoparticles-as-ph-responsive-carrier-of-methotrexate-for-rheumatoid-arthritis
#5
Md Mahmudul Alam, Hwa Seung Han, Shijin Sung, Jin Hee Kang, Keum Hee Sa, Hasan Al Faruque, Jungwan Hong, Eon Jeong Nam, In San Kim, Jae Hyung Park, Young Mo Kang
Methotrexate (MTX), an anchor drug for rheumatoid arthritis (RA), has been suffered from refractoriness and high toxicity limiting effective dosage. To mitigate these challenges, the ability to selectively deliver MTX to arthritis tissue is a much sought-after modality for the treatment of RA. In this study, we prepared mineralized nanoparticles (MP-HANPs), composed of PEGylated hyaluronic acid (P-HA) as the hydrophilic shell, 5β-cholanic acid as the hydrophobic core, and calcium phosphate (CaP) as the pH-responsive mineral...
March 11, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28285295/repeated-episodes-of-leukoencephalopathy-after-high-dose-methotrexate-in-a-child-with-acute-lymphoblastic-leukemia
#6
Teng-Fu Tsao, Yu-Hua Chao
No abstract text is available yet for this article.
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28278731/treatment-of-initial-parenchymal-central-nervous-system-involvement-in-systemic-aggressive-b-cell-lymphoma
#7
Marcel Nijland, Anne Jansen, Jeanette K Doorduijn, Roelien H Enting, Jacoline E C Bromberg, Hanneke C Kluin-Nelemans
Central nervous system (CNS) involvement in systemic B-cell non-Hodgkin lymphoma (B-NHL) at diagnosis (sysCNS) is rare. We investigated the outcome of 21 patients with sysCNS, most commonly diffuse large B-cell lymphoma, treated with high dose methotrexate (HD-MTX) and R-CHOP. The median number of cycles of HD-MTX and R-CHOP was 4 (range 1-8) and 6 (range 0-8), respectively. Consolidative whole brain radiotherapy (WBRT) was given to 33% (7/21) patients. With a median follow-up of 44 months the 3-year progression free survival (PFS) and overall survival (OS) were 45% (95%CI 34-56%) and 49% (95%CI 38-60%), respectively...
February 6, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28274253/phase-1b-randomized-double-blind-study-of-namilumab-an-anti-granulocyte-macrophage-colony-stimulating-factor-monoclonal-antibody-in-mild-to-moderate-rheumatoid-arthritis
#8
T W J Huizinga, A Batalov, R Stoilov, E Lloyd, T Wagner, D Saurigny, B Souberbielle, E Esfandiari
BACKGROUND: Namilumab (AMG203) is an immunoglobulin G1 monoclonal antibody that binds with high affinity to the GM-CSF ligand. This was a phase 1b, randomized, double-blind study (PRIORA) to assess namilumab in active, mild-to-moderate rheumatoid arthritis (RA). The primary outcome was the safety and tolerability of repeated subcutaneous injections of namilumab in patients with mild-to-moderate RA. METHODS: Adults with mild-to-moderate RA on stable methotrexate doses for ≥12 weeks were eligible...
March 9, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28270229/rituximab-versus-azathioprine-as-therapy-for-maintenance-of-remission-for-anti-neutrophil-cytoplasm-antibody-associated-vasculitis-ritazarem-study-protocol-for-a-randomized-controlled-trial
#9
Seerapani Gopaluni, Rona M Smith, Michelle Lewin, Carol A McAlear, Kim Mynard, Rachel B Jones, Ulrich Specks, Peter A Merkel, David R W Jayne
BACKGROUND: Rituximab is effective as therapy for induction of remission in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, the effect of rituximab is not sustained, and subsequent relapse rates are high, especially in patients with a history of relapse. There is a need to identify whether maintenance therapy with rituximab is superior to the current standard of azathioprine or methotrexate for prevention of relapse following induction with rituximab...
March 7, 2017: Trials
https://www.readbyqxmd.com/read/28267080/atic-gene-polymorphism-and-histologic-response-to-chemotherapy-in-pediatric-osteosarcoma
#10
Jeong A Park, Hee Young Shin
Accumulating evidence indicates that polymorphisms in folate pathway genes play a role in response to methotrexate (MTX) treatment in various diseases. This study explored the influence of these genetic polymorphisms on treatment outcome in pediatric osteosarcoma. Blood and tissue samples from 48 osteosarcoma patients were obtained, and the following polymorphisms were analyzed; SLC19A1 80G>A, DHFR 829C>T, MTHFR 677C>T, MTHFR 1298A>C, and ATIC 347C>G. We evaluated associations between these candidate gene polymorphisms and treatment outcome, including histologic response and event-free and overall survival, of patients treated with high-dose MTX...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28263383/results-of-a-randomized-prospective-clinical-trial-evaluating-metronomic-chemotherapy-in-nonmetastatic-patients-with-high-grade-operable-osteosarcomas-of-the-extremities-a-report-from-the-latin-american-group-of-osteosarcoma-treatment
#11
Andreza A Senerchia, Carla Renata Macedo, Sima Ferman, Marcelo Scopinaro, Walter Cacciavillano, Erica Boldrini, Vera Lúcia Lins de Moraes, Guadalupe Rey, Claudia T de Oliveira, Luis Castillo, Maria Tereza Almeida, Maria Luisa Borsato, Eduardo Lima, Daniel Lustosa, José Henrique Barreto, Tatiana El-Jaick, Simone Aguiar, Algemir Brunetto, Lauro Greggiani, Hugo Cogo-Moreira, Alvaro Atallah, Antonio Sergio Petrilli
BACKGROUND: Metronomic chemotherapy (MC) consists of the administration of a low dose of chemotherapy on a daily or weekly basis without a long break to achieve an antitumoral effect through an antiangiogenic effect or stimulation of the immune system. The potential effect of MC with continuous oral cyclophosphamide and methotrexate in patients with high-grade operable osteosarcomas (OSTs) of the extremities was investigated. METHODS: Patients with high-grade OSTs who were 30 years old or younger were eligible for registration at diagnosis...
May 15, 2017: Cancer
https://www.readbyqxmd.com/read/28261918/methotrexate-induced-pancytopenia-a-case-series-of-46-patients
#12
Sajal Ajmani, Yogesh Preet Singh, Shiva Prasad, Abhra Chowdhury, Amita Aggarwal, Able Lawrence, Ramnath Misra, Richa Mishra, Vikas Agarwal
AIM: Methotrexate (MTX) has the potential to cause serious adverse reactions and even mortality. We analyzed the predisposing factors and outcome in patients with MTX-induced pancytopenia admitted into our unit from 1996 to 2015. METHODS: Patients were identified by departmental database search. Pancytopenia was defined as white blood cell count (WBC) < 3500 cells/mm(3) , hemoglobin (Hb) < 11 g/dL and platelet count < 150 000 cells/mm(3) . Severe pancytopenia was defined as WBC < 2000 cells/mm(3) , Hb < 10 g/dL and platelet count < 50 000 cells/mm(3) ...
March 5, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28258828/dna-thioguanine-nucleotide-concentration-and-relapse-free-survival-during-maintenance-therapy-of-childhood-acute-lymphoblastic-leukaemia-nopho-all2008-a-prospective-substudy-of-a-phase-3-trial
#13
Stine Nygaard Nielsen, Kathrine Grell, Jacob Nersting, Jonas Abrahamsson, Bendik Lund, Jukka Kanerva, Ólafur Gísli Jónsson, Goda Vaitkeviciene, Kaie Pruunsild, Lisa Lyngsie Hjalgrim, Kjeld Schmiegelow
BACKGROUND: Adjustment of mercaptopurine and methotrexate maintenance therapy of acute lymphoblastic leukaemia by leucocyte count is confounded by natural variations. Cytotoxicity is primarily mediated by DNA-incorporated thioguanine nucleotides (DNA-TGN). The aim of this study was to establish whether DNA-TGN concentrations in blood leucocytes during maintenance therapy are associated with relapse-free survival. METHODS: In this substudy of the NOPHO ALL2008 phase 3 trial done in 23 hospitals in seven European countries (Denmark, Estonia, Finland, Iceland, Lithuania, Norway, and Sweden), we analysed data from centralised and blinded analyses of 6-mercaptopurine and methotrexate metabolites in blood samples from patients with non-high-risk childhood acute lymphoblastic leukaemia...
February 28, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28240590/a-meta-analysis-of-avascular-necrosis-in-systemic-lupus-erythematosus-prevalence-and-risk-factors
#14
Tatiana Nevskaya, Maeve P Gamble, Janet E Pope
OBJECTIVES: To determine the prevalence of and risk factors for avascular necrosis (AVN) in systemic lupus erythematosus (SLE). METHODS: MEDLINE, CINAHL, Web of Science, EMBASE and Cochrane Library were searched from inception to July, 2015 and a random effects model was used to combine frequencies; study quality was assessed using STROBE. RESULTS: 2,041 citations identified 62 articles. Many results had high heterogeneity. The prevalence of symptomatic AVN was 9% (range 0...
February 24, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28215362/efficacy-and-safety-of-sirukumab-in-patients-with-active-rheumatoid-arthritis-refractory-to-anti-tnf-therapy-sirround-t-a-randomised-double-blind-placebo-controlled-parallel-group-multinational-phase-3-study
#15
Daniel Aletaha, Clifton O Bingham, Yoshiya Tanaka, Prasheen Agarwal, Regina Kurrasch, Paul P Tak, Sharon Popik
BACKGROUND: Sirukumab, a human monoclonal antibody that selectively binds to the interleukin-6 cytokine with high affinity, is under development for the treatment of rheumatoid arthritis and other diseases. We aimed to assess the efficacy and safety of sirukumab for rheumatoid arthritis in a phase 3 study (SIRROUND-T). METHODS: We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre study at 183 hospitals and private rheumatology clinics in 20 countries (Argentina, Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, Lithuania, Mexico, Netherlands, Poland, Portugal, Russia, South Korea, Spain, Taiwan, UK, and USA)...
February 15, 2017: Lancet
https://www.readbyqxmd.com/read/28211579/impact-of-treatment-variability-on-survival-in-immuno-competent-and-immuno-compromised-patients-with-primary-central-nervous-lymphoma
#16
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)...
February 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28211077/severe-bullous-pemphigoid-associated-with-pembrolizumab-therapy-for-metastatic-melanoma-with-complete-regression
#17
O Rofe, G Bar-Sela, Z Keidar, T Sezin, C D Sadik, R Bergman
Bullous pemphigoid (BP) is considered to be a humorally mediated autoimmune disease, but autoreactive T-cells and T-regulatory cells (Tregs) have also been implicated in this disease. Tregs and the programmed death-1 (PD-1) : programmed death ligand (PD-L) pathway are both critical in terminating immune response, and elimination of either can result in breakdown of tolerance and development of autoimmunity. We report a patient with metastatic malignant melanoma (MM), who underwent pembrolizumab (anti-PD-1) therapy following unsuccessful treatment with ipilimumab [anti-cytotoxic T-lymphocyte-associated protein (CTLA)-4]...
April 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28209661/non-topical-management-of-recalcitrant-paediatric-atopic-dermatitis
#18
REVIEW
Jin Ho Chong, Mark Jean Aan Koh
Atopic dermatitis (AD) is a common chronic, pruritic skin disease in children. As the incidence of AD increases, especially in high-income countries, paediatricians may see an increasing number of recalcitrant AD cases in their practice. Although these cases are principally managed by paediatric dermatologists, it is important for paediatricians to be aware of the use and side effects of non-topical treatment like phototherapy and systemic agents as well as the evidence for alternative treatment, which caregivers may ask about...
February 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28197276/percutaneous-coronary-intervention-safety-of-methotrexate-and-its-possible-benefits-on-restenosis-after-bare-metal-stent-deployment
#19
Viviane Gouveia, Dinaldo C Oliveira, Emmanuele Tenorio, Norma Brito, Emanuel Sarinho
BACKGROUND: Percutaneous coronary intervention (PCI) revolutionized treatment of coronary artery disease. Drug-eluting stents are effective and safe but their cost is high, especially for some countries. The primary objective was to evaluate the safety of methotrexate (MTX) in patients who underwent PCI and the secondary goal was to evaluate the possibility that MTX has an impact on restenosis. METHODS: This was a transversal, prospective and descriptive study that recruited 16 patients in whom PCI was planned...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28190982/dermatomyositis-leading-to-necrotizing-vasculitis-a-perfect-response-to-applied-therapy
#20
Mahmood Akbaryan, Farideh Darabi, Zahra Soltani
Dermatomyositis is an idiopathic inflammatory myopathy that cause skin and muscle complications. The ethiology is not understood well yet. Released cytokines including interferon and interleukins are suggested to make inflammatory responses in the skin or muscle. Muscle weakness and skin lesions including heliotrope rash, shawl sign and Gottron's papules are the most common symptoms. A biopsy (muscle or skin) is always the most reliable method for diagnosis. Corticosteroids in association with immunosuppressive agents are used as standard treatment...
December 2016: International Journal of Biomedical Science: IJBS
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