Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies. Issue 4 (18th December 2015)

• Record Type: Journal Article
• Authors: Badke, Colleen; Fleming, Amy; Iqbal, Asneha; Khilji, Ohmed; Parhas, Sophia; Weinstein, Joanna; Morgan, Elaine; Hijiya, Nobuko
• Is Part Of: Pediatric blood & cancer. Volume 63:Issue 4(2016)
• Page Start: 723
• Page End: 726
• Publication Date: 2015-12-18
• Subjects: acute lymphoblastic leukemia -- lymphoblastic lymphoma -- methotrexate -- neurotoxicity; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.25850
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract : Methotrexate is associated with neurologic side effects. It is recommended that patients who developed neurotoxicity be rechallenged with methotrexate, but little is known about the safety of this approach. We performed a chart review to identify patients who received high‐dose or intrathecal (IT) methotrexate. Twenty‐one of 298 patients (7%) experienced neurologic symptoms attributed to methotrexate treatment in the premaintenance phase. Seventeen of these patients were rechallenged with IT methotrexate and 13 (76%) had no further neurotoxic events. No patients rechallenged during maintenance (n = 9) experienced recurrence of neurotoxic events. It is safe to rechallenge with IT methotrexate in maintenance.