Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies

Colleen Badke, Amy Fleming, Asneha Iqbal, Ohmed Khilji, Sophia Parhas, Joanna Lynn Weinstein, Elaine R Morgan, Nobuko Hijiya*

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)723-726
Number of pages4
JournalPediatric Blood and Cancer
Volume63
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Hematologic Neoplasms
Methotrexate
Maintenance
Neurologic Manifestations
Nervous System
Safety
Recurrence

Keywords

  • Acute lymphoblastic leukemia
  • Lymphoblastic lymphoma
  • Methotrexate
  • Neurotoxicity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Badke, Colleen ; Fleming, Amy ; Iqbal, Asneha ; Khilji, Ohmed ; Parhas, Sophia ; Weinstein, Joanna Lynn ; Morgan, Elaine R ; Hijiya, Nobuko. / Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies. In: Pediatric Blood and Cancer. 2016 ; Vol. 63, No. 4. pp. 723-726.
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Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies. / Badke, Colleen; Fleming, Amy; Iqbal, Asneha; Khilji, Ohmed; Parhas, Sophia; Weinstein, Joanna Lynn; Morgan, Elaine R; Hijiya, Nobuko.

In: Pediatric Blood and Cancer, Vol. 63, No. 4, 01.04.2016, p. 723-726.

Research output: Contribution to journalArticle

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T1 - Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies

AU - Badke, Colleen

AU - Fleming, Amy

AU - Iqbal, Asneha

AU - Khilji, Ohmed

AU - Parhas, Sophia

AU - Weinstein, Joanna Lynn

AU - Morgan, Elaine R

AU - Hijiya, Nobuko

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AB - 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.

KW - Acute lymphoblastic leukemia

KW - Lymphoblastic lymphoma

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