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high dose methotrexate

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https://www.readbyqxmd.com/read/28525903/polymorphisms-in-methotrexate-transporters-and-their-relationship-to-plasma-methotrexate-levels-toxicity-of-high-dose-methotrexate-and-outcome-of-pediatric-acute-lymphoblastic-leukemia
#1
Shu-Guang Liu, Chao Gao, Rui-Dong Zhang, Xiao-Xi Zhao, Lei Cui, Wei-Jing Li, Zhen-Ping Chen, Zhi-Xia Yue, Yuan-Yuan Zhang, Min-Yuan Wu, Jian-Xiang Wang, Zhi-Gang Li, Hu-Yong Zheng
High-dose methotrexate (HDMTX) plays an important role in the treatment of acute lymphoblastic leukemia (ALL) although there is great inter-patient variability in the efficacy and toxicity of MTX. The relationship between polymorphisms in genes encoding MTX transporters and MTX response is controversial. In the present study, 322 Chinese children with standard- and intermediate-risk ALL were genotyped for 12 polymorphisms. SLCO1B1 rs10841753 showed a significant association with plasma MTX levels at 48 h (P = 0...
May 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28523060/management-options-for-interstitial-ectopic-pregnancies-a-case-series
#2
Ilker Kahramanoglu, Zahid Mammadov, Hasan Turan, Aslihan Urer, Abdullah Tuten
OBJECTIVE: Ectopic pregnancy in the interstitial part of the Fallopian tubes can be life-threatining considering the thin myometrial tissue surrounding the gestational sac and highly vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. The diagnosis and management is challenging. Conservative, medical, and surgical treatment options should be considered based on individual patient factors. METHODS: Four women were diagnosed with interstitial pregnancy in last five years in our tertiary center...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28515935/methotrexate-encephalopathy-two-cases-in-adult-cancer-patients-who-recovered-with-pathophysiologically-based-therapy
#3
Shodeinde A Coker, David A Pastel, Melissa C Davis, Elizabeth M Bengtson, Camilo E Fadul, Lionel D Lewis
BACKGROUND/OBJECTIVES: Neurotoxicity is a serious and sometimes fatal adverse effect that can occur following methotrexate treatment. We describe two adult patients with hematological malignancies with methotrexate encephalopathy who recovered with dextromethorphan therapy. RESULTS: Case 1: A 24-year-old male with acute lymphoblastic leukemia developed the acute onset of bilateral facial weakness and slurred speech after his first treatment with high-dose intravenous methotrexate...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28508176/the-prognostic-role-of-cd68-and-foxp3-expression-in-patients-with-primary-central-nervous-system-lymphoma
#4
Hyunsoo Cho, Se Hoon Kim, Soo-Jeong Kim, Jong Hee Chang, Woo Ick Yang, Chang-Ok Suh, June-Won Cheong, Yu Ri Kim, Jung Yeon Lee, Ji Eun Jang, Yundeok Kim, Yoo Hong Min, Jin Seok Kim
The prognostic role of CD68 and FoxP3 in primary central nervous system lymphoma (PCNSL) has not been evaluated. Thus, we examined the prognostic significance of CD68 and FoxP3 expression in tumor samples of 76 newly diagnosed immunocompetent PCNSL patients. All patients were treated initially with high-dose methotrexate (HD-MTX)-based chemotherapy, and 16 (21.1%) patients received upfront autologous stem cell transplantation (ASCT) consolidation. High expression of CD68 (>55 cells/high-power field) or FoxP3 (>15 cells/high-power field) was observed in 10 patients, respectively...
May 15, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28506237/clinical-and-mri-outcome-of-cervical-spine-lesions-in-children-with-juvenile-idiopathic-arthritis-treated-with-anti-tnf%C3%AE-drugs-early-in-disease-course
#5
Damjana Ključevšek, Nina Emeršič, Nataša Toplak, Tadej Avčin
BACKGROUNDS: The purpose of the study was to evaluate the clinical and magnetic resonance imaging (MRI) outcome of cervical spine arthritis in children with juvenile idiopathic arthritis (JIA), who received anti-TNFα early in the course of cervical spine arthritis. METHODS: Medical charts and imaging of JIA patients with cervical spine involvement were reviewed in this retrospective study. Data, including age at disease onset, JIA type, disease activity, treatment and clinical outcome were collected...
May 15, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28502935/two-cases-of-neurolymphomatosis-with-fatal-bilateral-vocal-cord-paralysis-that-were-diagnosed-with-18-f-fluorodeoxyglucose-positron-emission-tomography-fdg-pet-ct
#6
Yuichiro Ono, Yasuhiro Kazuma, Yotaro Ochi, Ryosuke Matsuoka, Yukihiro Imai, Takayuki Ishikawa
Neurolymphomatosis is a rare entity defined as nerve infiltration by neurotropic abnormal lymphocytes which can lead to the development of neuropathy, with typical presentations including pain, hypoesthesia, paresthesis and palsy. We herein report two cases where critical bilateral vocal cord paralysis due to neurolymphomatosis in recurrent nerves occurred in refractory Burkitt lymphoma and adult T-cell lymphoma patients. High-dose methotrexate and intrathecal chemotherapy injection for the nervous lesions were ineffective, and the patients died...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28493546/palmar-plantar-erythrodysesthesia-syndrome-following-treatment-with-high-dose-methotrexate-or-high-dose-cytarabine
#7
Seth E Karol, Wenjian Yang, Colton Smith, Cheng Cheng, Clinton F Stewart, Sharyn D Baker, John T Sandlund, Jeffrey E Rubnitz, Michael W Bishop, Alberto S Pappo, Sima Jeha, Ching-Hon Pui, Mary V Relling
BACKGROUND: Palmar-plantar erythrodysesthesia syndrome (PPES) is an uncommon side effect of high-dose cytarabine or methotrexate. Prior case reports of PPES have been limited, and the predisposing factors for the development of PPES remain unknown. METHODS: A review of databases identified 22 patients (1.3%) who developed 39 episodes of PPES among 1720 patients after treatment with high-dose cytarabine or methotrexate. RESULTS: Symptoms lasted a mean of 6...
May 11, 2017: Cancer
https://www.readbyqxmd.com/read/28491318/recovery-of-methotrexate-induced-anuric-acute-kidney-injury-after-glucarpidase-therapy
#8
James Harms, Ayaz Khawaja, Maria Taylor, Xiaosi Han, Michal Mrug
OBJECTIVES: This case report describes two cases of high-dose methotrexate-induced nephrotoxicity: death in the case of conventional supportive care and successful renal function recovery in a patient treated with glucarpidase and continuous dialysis. METHODS: High dose methotrexate is widely used for management of adult and pediatric malignancies. However, high-dose methotrexate-induced renal nephrotoxicity may cause severe, even lethal complications. Here we present examples of such outcomes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28481421/immunomodulatory-treatment-other-than-corticosteroids-immunoglobulin-and-plasma-exchange-for-chronic-inflammatory-demyelinating-polyradiculoneuropathy
#9
REVIEW
Mohamed Mahdi-Rogers, Ruth Brassington, Angela A Gunn, Pieter A van Doorn, Richard Ac Hughes
BACKGROUND: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a disease that causes progressive or relapsing and remitting weakness and numbness. It is probably caused by an autoimmune process. Immunosuppressive or immunomodulatory drugs would be expected to be beneficial. This review was first published in 2003 and has been updated most recently in 2016. OBJECTIVES: To assess the effects of immunomodulatory and immunosuppressive agents other than corticosteroids, immunoglobulin, and plasma exchange in CIDP...
May 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28476189/analysis-of-thiopurine-s-methyltransferase-deficient-alleles-in-acute-lymphoblastic-leukemia-patients-in-mexican-patients
#10
Silvia Jiménez-Morales, Mireya Ramírez-Florencio, Juan Manuel Mejía-Aranguré, Juan Carlos Núñez-Enríquez, Carolina Bekker-Mendez, José Luis Torres-Escalante, Janet Flores-Lujano, Elva Jiménez-Hernández, María Del Carmen Rodríguez-Zepeda, Yelda A Leal, Pablo Miguel González-Montalvo, Francisco Pantoja-Guillen, José Gabriel Peñaloza-Gonzalez, Erick Israel Gutiérrez-Juárez, Nora Nancy Núñez-Villegas, Maria Luisa Pérez-Saldivar, Francisco Xavier Guerra-Castillo, Luz Victoria Flores-Villegas, María Teresa Ramos-Cervantes, José Manuel Fragoso, María Guadalupe García-Escalante, Doris Del Carmen Pinto-Escalante, Julián Ramírez-Bello, Alfredo Hidalgo-Miranda
BACKGROUND AND AIMS: It has been demonstrated that heterozygote and homozygote thiopurine S-methyltransferase (TPMT) mutant allele carriers are at high risk to develop severe and potentially fatal hematopoietic toxicity after treatment with standard doses of 6-mercaptopurine (6-MP) and methotrexate (MX). Those drugs are the backbone of acute lymphoblastic leukemia (ALL) and several autoimmune disease treatments. We undertook this study to determine the frequency of the TPMT deficient alleles in children with ALL and non-ALL subjects from Mexico City and Yucatan, Mexico...
November 2016: Archives of Medical Research
https://www.readbyqxmd.com/read/28475384/optimizing-pharmacologic-management-of-inflammatory-bowel-disease
#11
Shannon Chang, Stephen Hanauer
As our medical armamentarium for IBD continues to expand, it is essential that clinicians understand both optimizing and sequencing of individual and combination therapeutic approaches with available medications. Areas covered: This review summarizes dosing strategies and therapeutic drug monitoring for pharmacologic optimization in IBD. Aminosalicylates remain first-line therapies for mild-to-moderate UC but have limited evidence of efficacy in CD. Budesonide provides an alternative to aminosalicylates when targeted to appropriate sites in the distal small bowel and colon, as do conventional corticosteroids when applied rectally...
June 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28467782/methotrexate-cytarabine-dexamethasone-combination-chemotherapy-with-or-without-rituximab-in-patients-with-primary-central-nervous-system-lymphoma
#12
Xuefei Sun, Jing Liu, Yaming Wang, Xueyan Bai, Yuedan Chen, Jun Qian, Hong Zhu, Fusheng Liu, Xiaoguang Qiu, Shengjun Sun, Nan Ji, Yuanbo Liu
PURPOSE: High-dose methotrexate based chemotherapy is the standard treatment for patients with newly diagnosed primary central nervous system lymphoma (PCNSL). The role of rituximab is controversial because of its large size, which limits its penetration of the blood-brain barrier. In this study, we investigated the efficacy and tolerability of adding rituximab to methotrexate-cytarabine-dexamethasone combination therapy (RMAD regimen). RESULTS: The patients treated with RMAD had a complete remission rate of 66...
April 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28455827/characteristics-and-risk-factors-of-lymphoproliferative-disorders-among-patients-with-rheumatoid-arthritis-concurrently-treated-with-methotrexate-a-nested-case-control-study-of-the-iorra-cohort
#13
Yoko Shimizu, Ayako Nakajima, Eisuke Inoue, Kumi Shidara, Naoki Sugimoto, Yohei Seto, Eiichi Tanaka, Shigeki Momohara, Atsuo Taniguchi, Hisashi Yamanaka
The purpose of the study is to demonstrate the characteristics of lymphoproliferative disorders (LPDs) in patients with rheumatoid arthritis (RA) and risk factors for LPD among RA patients concurrently treated with methotrexate (MTX). Among patients who participated in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort study in October 2010, past existence of LPD from patient's report was confirmed through medical charts. Background factors, LPD pathological findings, and the clinical courses of LPD and RA after LPD were assessed...
April 28, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28455583/neurotoxicity-after-high-dose-methotrexate-mtx-is-adequately-explained-by-insufficient-folinic-acid-rescue
#14
REVIEW
Ian Joseph Cohen
PURPOSE: To challenge the view that the dose of folinic acid rescue after high-dose methotrexate (MTX) has no significance in the prevention of neurotoxicity and to present the minority view that neurotoxicity can be prevented by an adequate dose of folinic acid, without compromising treatment results. Several fallacies that led to the misunderstanding of post MTX neurotoxicity are presented. METHODS: Data mining using search engines was used to find relevant publications, and an e-mail survey of more than 60 authors of articles in this field was performed...
June 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28447926/treatment-of-primary-central-nervous-system-posttransplant-lymphoproliferative-disorder-in-an-adult-kidney-transplant-recipient-a-case-report
#15
Mashya Abbassi, Roger Riley, Mark Malkin, Yang Tang, Bipin Rajendran, Victor Yazbeck
Posttransplant lymphoproliferative disorder is a serious complication of solid-organ transplant. Extranodal involvement is common; however, isolated involvement of the central nervous system is extremely rare and represents a particularly difficult therapeutic challenge with no current consensus on optimal treatment. Here, we describe a 70-year-old woman who developed Epstein-Barr virus-related primary central nervous system lymphoma 19 months after kidney transplant. Immunosuppression was reduced, and the patient was started on high-dose methotrexate, which was complicated by acute kidney injury and discontinued...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28447548/preparation-of-wormlike-polymeric-nanoparticles-coated-with-silica-for-delivery-of-methotrexate-and-evaluation-of-anticancer-activity-against-mcf7-cells
#16
Farhad Gharebaghi, Naser Dalali, Ebrahim Ahmadi, Hossein Danafar
Methotrexate is one of the most effective drugs that is commonly used in the treatment of cancer. However, its application is limited due to low solubility, high toxicity and rapid metabolism. Therefore, in the present study, worm-like polymeric nanoparticles as carrier of methotrexate were prepared using biodegradable copolymers (mPEG-PCL). The impact of nanoparticles' geometry on the loading, delivery and drug's anti-cancer activity was investigated. The di-block copolymer mPEG-PCL was being synthesized by a ring opening polymerization of ɛ-caprolactone in the presence of mPEG as the initiator and Sn(oct)2 as the catalyst...
April 2017: Journal of Biomaterials Applications
https://www.readbyqxmd.com/read/28435338/recommendations-for-optimizing-methotrexate-treatment-for-patients-with-rheumatoid-arthritis
#17
REVIEW
Alfonso E Bello, Elizabeth L Perkins, Randy Jay, Petros Efthimiou
Methotrexate (MTX) remains the cornerstone therapy for patients with rheumatoid arthritis (RA), with well-established safety and efficacy profiles and support in international guidelines. Clinical and radiologic results indicate benefits of MTX monotherapy and combination with other agents, yet patients may not receive optimal dosing, duration, or route of administration to maximize their response to this drug. This review highlights best practices for MTX use in RA patients. First, to improve the response to oral MTX, a high initial dose should be administered followed by rapid titration...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28434043/early-whole-brain-radiotherapy-in-primary-cns-lymphoma-negative-impact-on-quality-of-life-in-the-randomized-g-pcnsl-sg1-trial
#18
Ulrich Herrlinger, Niklas Schäfer, Rolf Fimmers, Frank Griesinger, Michael Rauch, Heinz Kirchen, Patrick Roth, Martin Glas, Michael Bamberg, Peter Martus, Eckhard Thiel, Agnieszka Korfel, Michael Weller
PURPOSE: In the randomized G-PCNSL-SG-1 trial, the addition of whole brain radiotherapy (45 Gy) to high-dose methotrexate (HD-MTX)-based chemotherapy (early WBRT arm) did not prolong overall survival (OS) as compared to HD-MTX-based chemotherapy alone (no early WBRT arm) in primary CNS lymphoma (PCNSL) patients. To determine whether WBRT might lead to quality of life (QoL)-relevant late neurotoxicity, this trial prospectively monitored QoL. METHODS: QoL measurements were performed using the EORTC-QLQ-C30 and BN20 questionnaires and combined with repeated Mini Mental State Examinations (MMSE)...
April 22, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28432587/rituximab-methotrexate-procarbazine-vincristine-and-intensified-cytarabine-consolidation-for-primary-central-nervous-system-lymphoma-pcnsl-in-the-elderly-a-loc-network-study
#19
Caroline Houillier, Hervé Ghesquières, Cécile Chabrot, Carole Soussain, Guido Ahle, Sylvain Choquet, Emmanuelle Nicolas-Virelizier, Jacques-Olivier Bay, Jacques Vargaftig, Claude Gaultier, Valérie Touitou, Nadine Martin-Duverneuil, Nathalie Cassoux, Magali Le Garff-Tavernier, Myrto Costopoulos, Pierre Faurie, Khê Hoang-Xuan
Primary CNS lymphoma (PCNSL) is chemosensitive to high-dose methotrexate-based chemotherapy. However, responses in the elderly are short-lasting and outcome is poor. Given that radiotherapy and intensive chemotherapy expose elderly to severe toxicities, alternative consolidation approaches need to be evaluated. In this multicenter study, we retrospectively analyzed consecutive patients with newly-diagnosed PCNSL, aged >60, treated with a (R)-MPV-AAA regimen. The regimen consisted of three 28-day cycles of methotrexate (3...
April 21, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28427529/primary-central-nervous-system-lymphoma
#20
REVIEW
Giovanni Citterio, Michele Reni, Gemma Gatta, Andrés José Maria Ferreri
Primary CNS lymphomas (PCNSL) represent a subgroup of malignancies with specific characteristics, aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumour burden and/or histological type. Despite a high chemo- and radiosensitivity, remissions are frequently shortlasting, mainly because the blood brain-barrier limits the access of many drugs to the CNS. Moreover, survivor patients are at high risk of developing severe treatment-related toxicity, mainly disabling neurotoxicity, raising the question of how to balance therapy intensification with side-effects control...
May 2017: Critical Reviews in Oncology/hematology
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