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high dose methotrexate

Thomas A Ollila, Adam J Olszewski
Diffuse large B cell lymphoma (DLBCL) arises from extranodal organs in about 30% of cases. Its prognosis and risk of recurrence in the central nervous system (CNS) vary according to the primary site of origin. Recent studies begin to clarify these differences using molecular classification. Testicular, breast, and uterine DLBCL (as well as possibly primary cutaneous DLBCL, leg-type) share a high prevalence of the non-germinal center B cell (non-GCB) phenotype and the MYD88/CD79B-mutated (MCD) genotype. These biologic features, which resemble primary CNS lymphoma, may underlie their stage-independent propensity for CNS involvement...
June 21, 2018: Current Treatment Options in Oncology
Hitoshi Kayatani, Naoki Nitta, Suzuko Moritani, Kazuhiko Nozaki
Background: Primary lymphomas in the choroid plexus are much less frequent than primary lymphomas in the brain parenchyma. Case Description: A 66-year-old male patient was referred to our department with a right intraventricular mass that had been diagnosed by biopsy at another hospital as anaplastic ependymoma. The patient underwent subtotal removal of the tumor via a transcortical inferior temporal gyrus approach. The mass was attached to the choroid plexus in the right atrium...
2018: Surgical Neurology International
Claas H Hinze, Fabian Speth, Prasad T Oommen, Johannes-Peter Haas
BACKGROUND: Juvenile Dermatomyositis (JDM) is a rare pediatric autoimmune disease with broad variations of the individual course. Data on the optimal management are mostly lacking. Currently treatment decisions are often based on experts' opinions. In order to develop consensus-based treatment strategies for JDM in Germany a survey was pursued to analyze the current clinical practice. METHODS: An online survey addressing all members of the Society for Pediatric Rheumatology (GKJR) in Germany and Austria and pediatric neurologists with expertise in JDM was performed in February/March of 2016...
June 20, 2018: Pediatric Rheumatology Online Journal
Chuanyin Sun, Yingwan Luo, Hongyan Tong, Guanhua Xu, Jin Lin
RATIONALE: Dysregulated immune function in rheumatoid arthritis (RA) might lead to the development of myelodysplastic syndrome (MDS). Serum interleukin-6 (IL-6) concentrations are increased in both RA and MDS patients. PATIENT CONCERNS: A 58-year-old woman presented with severe RA. During a recent 8-month period, the patient experienced swelling in multiple joints, dizziness, and severe anemia. The symptoms responded poorly to oral corticosteroids and methotrexate (MTX)...
June 2018: Medicine (Baltimore)
N Oosterom, N F Dirks, S G Heil, R de Jonge, W J E Tissing, R Pieters, M M van den Heuvel-Eibrink, A C Heijboer, S M F Pluijm
PURPOSE: Children with acute lymphoblastic leukemia (ALL) are at increased risk of vitamin D deficiency, which might make them more susceptible to developing adverse events. Previous studies showed that low vitamin D levels were associated with an increased inflammatory mucosal state and impaired mucosal tissue barriers. We examined the prevalence of vitamin D deficiency and studied the association between vitamin D levels and methotrexate (MTX)-induced oral mucositis in pediatric ALL...
June 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Maurizio Benucci, Francesca Bandinelli, Arianna Damiani, Francesca Li Gobbi, Maria Infantino, Valentina Grossi, Mariangela Manfredi
Background: Rheumatoid arthritis patients are exposed to a high risk of cardiovascular morbidity and mortality even in the early phases of the disease. Methods: We evaluated carotid common carotid intimal media thickness (ccIMT) intimal thickness and brachial flow-mediated dilation (FMD) of 45 rheumatoid arthritis patients without known cardiovascular risk factors or heart disease on a stable dose of prednisone 5.2±1.2 mg/day and Methotrexate 11.5±2.1 mg at baseline (T0) and after 12 months (T1) of treatment with Abatacept 125 mg/week...
2018: Journal of Inflammation Research
Lobna Ben Mahmoud, Moez Mdhaffar, Rim Frikha, Hanen Ghozzi, Ahmed Hakim, Zouheir Sahnoun, Moez Elloumi, Khaled Zeghal
BACKGROUND: Methotrexate (MTX) is a key component of acute lymphoblastic leukemia (ALL) therapy, but it is associated with serious toxicities in a considerable number of patients. OBJECTIVES: The aim of the current study was to determine which variables were associated with MTX toxicity in children, adolescents and young adults with ALL. MATERIAL AND METHODS: In this prospective study, 35 patients with newly diagnosed ALL, treated according to the 58951 European Organization for Research and Treatment of Cancer - Children's Leukemia Group (EORTC-CLG) protocol, were prospectively enrolled...
June 18, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Shenghui Mei, Xiaoxu Shi, Yaming Du, Yong Cui, Chun Zeng, Xiaohui Ren, Kefu Yu, Zhigang Zhao, Song Lin
The plasma concentrations of methotrexate (MTX) and its major metabolite 7-hydroxy methotrexate (7-OH-MTX) are highly correlated with the toxicities in patients with high-dose MTX therapy. Routine monitoring of MTX and 7-OH-MTX plasma levels is useful for dose adjustment of rescue drugs and toxicity prevention. A UHPLC-MS/MS method for simultaneous determination of plasma MTX and 7-OH-MTX was developed, validated, and applied in 181 plasma samples. The ion transition was m/z 455.2 → 308.2 for MTX and m/z 471...
June 11, 2018: Journal of Pharmaceutical and Biomedical Analysis
Ellen D McPhail, Matthew J Maurer, William R Macon, Andrew L Feldman, Paul J Kurtin, Rhett P Ketterling, Rakhee Vaidya, James R Cerhan, Stephen M Ansell, Luis F Porrata, Grzegorz S Nowakowski, Thomas E Witzig, Thomas M Habermann
High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-/triple-hit lymphoma) has an aggressive clinical course. We investigated prognostic value of transformation from low-grade lymphoma, cytologic features (high grade versus large cell), MYC gene rearrangement partners (immunoglobulin versus nonimmunoglobulin gene), and treatment. We evaluated 100 adults with double-/triple-hit lymphoma, reviewing cytologic features; cell of origin; and rearrangements of MYC, BCL2, and BCL6 using MYC, BCL2, and BCL6 break-apart and IGH/MYC, IGL/MYC, IGK/MYC, and IGH/BCL2 dual-fusion interphase fluorescence in situ hybridization probes...
June 14, 2018: Haematologica
Xiao Zhao, Juan Long, Fei Liang, Nan Liu, Yuying Sun, Yongzhi Xi
Antigen-specific tolerizing DNA vaccines are one of the most promising strategies for rheumatoid arthritis (RA) treatment, and act by inducing potent immune tolerance instead of generalized immunosuppression. Recently, we developed a novel antigen-specific tolerizing DNA vaccine coding for chicken type II collagen (pcDNA-CCOL2A1), and confirmed its potent therapeutic efficacy in an established rat model of collagen-induced arthritis (CIA). Here we report the prophylactic vaccination efficacy of a single 300ug/kg dose of pcDNA-CCOL2A1 against CIA incidence, severity, and onset...
June 14, 2018: Human Gene Therapy
Antoine Rostang, Marion Mosca, Morgan Jeannin, Coralie Luissiez, Philippe Berny, Isabelle Fourel, Didier Pin, Caroline Prouillac
Methotrexate may be an alternative to ciclosporin in the treatment of canine atopic dermatitis (cAD) as suggested by recent data. The aim of the study was to investigate both the tolerance and the pharmacokinetic behavior of methotrexate (MTX) in plasma, following intravenous (i.v.), subcutaneous (s.c.) or oral (OR) administration over several weeks. Six healthy dogs were given oral MTX once a week, respectively, per dog at 2.5 mg/1 week, 5 mg/4 weeks, 7.5 mg/3 weeks, 10 mg/6 weeks and 12.5 mg/5 weeks...
June 12, 2018: Journal of Veterinary Pharmacology and Therapeutics
Seo-Yeon Ahn, Seong Young Kwon, Sung-Hoon Jung, Jae-Sook Ahn, Su Woong Yoo, Jung-Joon Min, Hee-Seung Bom, So Yeon Ki, Hyeoung-Joon Kim, Je-Jung Lee, Sang Yun Song, Deok-Hwan Yang
PURPOSE: Primary central nervous system lymphoma (PCNSL) has a poor prognosis. There has been limited study evaluating the role of interim PET/CT in PCNSL. This prospective study investigated the interim response using sequential brain PET/CT with C-methionine (C-MET) to provide prognostic information during the treatment of PCNSL. MATERIALS AND METHODS: A total of 26 immunocompetent patients recently diagnosed with PCNSL were evaluated. Brain MRI and C-MET PET/CT were performed at the time of diagnosis and after 4 cycles of high-dose methotrexate-based induction chemotherapy...
June 5, 2018: Clinical Nuclear Medicine
Kota Shimada, Kyoko Yokosuka, Takahiro Nunokawa, Shoji Sugii
To compare Pneumocystis pneumonia (PCP) in patients with rheumatoid arthritis (RA) with PCP in patients with non-RA connective tissue diseases (CTDs) in order to clarify the characteristics of the former. We extracted consecutive patients satisfying the following criteria for "clinical PCP": (1) positive plasma β-D-glucan, (2) PCP-compatible computed tomography findings of the lung, and (3) successful treatment with antipneumocystic antibiotics. Patients who underwent methylprednisolone "pulse" therapy or sufficient antibiotics to cure bacterial pneumonia were excluded...
June 6, 2018: Clinical Rheumatology
Sylejman Rexhepi, Mjellma Rexhepi, Blerta Rexhepi, Vjollca Sahatçiu-Meka, Vigan Mahmutaj
AIM: This study aims to evaluate the efficacy of Methotrexate (MTX) alone and combined therapy with Etanercept (ETN) and Methotrexate in patients with active rheumatoid arthritis (RA). METHODS: In the randomised control study, conducted in the period from March 2014 until March 2016, we evaluated the efficacy of the treatment of patients with RA with MTX as monotherapy and combination treatment with MTX and ETN. In the Clinic of Rheumatology in Prishtina, 90 adult patients with RA were treated in combination with ETN (doses of 50 mg subcutaneously/weekly), with oral MTX (doses up to 20 mg weekly), and MTX alone (doses up to 20 mg weekly) during this period of two years...
May 20, 2018: Open Access Macedonian Journal of Medical Sciences
Ennio Giulio Favalli, Andrea Becciolini, Martina Biggioggero, Ilaria Bertoldi, Chiara Crotti, Maria Gabriella Raimondo, Antonio Marchesoni
Objective: To evaluate the pattern of prescription and maintenance over time of concomitant methotrexate (MTX), and its impact on a 2-year clinical response in a cohort of rheumatoid arthritis (RA) patients treated with a first-line tumor necrosis factor alpha inhibitor (TNFi). Patients and methods: The study population included all RA patients receiving adalimumab or etanercept a as first-line biologic drug, extracted from a local registry. Enrolled patients were stratified into 3 subgroups according to baseline concomitant MTX: no MTX, low-dose MTX (≤10 mg/wk), and high-dose MTX (≥12...
2018: Drug Design, Development and Therapy
Carlos D Flombaum, Dazhi Liu, Shirley Qiong Yan, Amelia Chan, Sherry Mathew, Paul A Meyers, Ilya G Glezerman, Thangamani Muthukumar
BACKGROUND: Acute kidney injury complicating high-dose methotrexate therapy increases the risk for severe mucositis, myelosuppression, and death. It is unclear whether high-dose leucovorin and supportive therapy without the use of glucarpidase can reduce toxicity from high-dose methotrexate. STUDY DESIGN: The charts of all patients at Memorial Sloan Kettering Cancer Center whose methotrexate drug levels at 48 or 72 hours after administration were ≥10 times the toxic level were reviewed between January 2000 and December 2011...
June 4, 2018: Pharmacotherapy
Gülşah Akdemir, Iris M Markusse, Sytske Anne Bergstra, Robbert J Goekoop, Esmeralda T Molenaar, Johannes H L M van Groenendael, Pit J S M Kerstens, Willem F Lems, Tom W J Huizinga, Cornelia F Allaart
Objectives: To compare outcomes of targeted treatment aimed at either low disease activity or remission in patients with early active rheumatoid arthritis (RA). Methods: Five-year outcomes were compared in 133 patients with early active RA (1987), starting with methotrexate, sulfasalazine and tapered high dose of prednisone (arm 3 of the BehandelStrategieën (Treatment Strategies for Rheumatoid Arthritis) (BeSt) study), targeted at Disease Activity Score (DAS) ≤2...
2018: RMD Open
M A Dijkman, D W de Lange, I de Vries
No abstract text is available yet for this article.
May 2018: Netherlands Journal of Medicine
Tolga Mercantepe, Yıldıray Kalkan, Levent Tumkaya, İbrahim Sehitoglu, Filiz Mercantepe, Sermet Yıldırmıs
BACKGROUND: Methotrexate (MTX), a folate antagonist, is commonly used in the treatment of many different types of cancer and inflammatory diseases, including pancreatic cancer, although its side effects on the pancreas have not yet been researched. The mechanism of MTX-induced toxicity is not well known, and it has been reported in high-dose toxicity studies that the pancreas is sensitive to toxic effects. OBJECTIVES: The aim of our study was to determine whether adalimumab (ADA) has a preventive effect on MTX-induced pancreas toxicity in rats...
May 24, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Bo Wang, Hao Yao, Xianbiao Xie, Junqiang Yin, Changye Zou, Gang Huang, Jingnan Shen
PURPOSE: This study aimed to explore whether peak serum methotrexate concentration (Cmax ) correlated with adverse events, overall survival (OS) and event-free survival (EFS) in patients with primary extremity osteosarcoma. METHODS: Patients with extremity osteosarcoma who were treated at our center between 2005 and 2015 were retrospectively studied. All the patients were Enneking stage II and had received standard perioperative chemotherapy composed of high-dose methotrexate, doxorubicin, cisplatin and ifosfamide...
May 28, 2018: Cancer Chemotherapy and Pharmacology
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