Transient neurologic dysfunction following moderate‐dose methotrexate for undifferentiated lymphoma

Roy L. Martino*, Al B. Benson, James A. Merritt, Jeffrey J. Brown, John R. Lesser

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Two patients, aged 24 and 19 years, who had undifferentiated lymphoma, developed the acute onset of focal neurologic deficits 10 days after treatment with moderate‐dose methotrexate (2.76 g/m2 by 42‐hour intravenous infusion) and 12.5 mg of intrathecal methotrexate. Prior chemotherapy also included intravenous cyclophosphamide, doxorubicin, vincristine, oral prednisone, and intrathecal cytosine arabinoside. Dysarthria with left hemiparesis was noted in one patient and inability to speak and quadriparesis in the other. Cerebrospinal fluid and cranial computerized tomography results were normal; however, EEGs showed focal abnormalities in both patients. Full neurologic recovery occurred within 48 hours. These symptoms developed early in the course of treatment and have not recurred in one patient who continued to receive the same regimen. The mechanism for this neurologic dysfunction is unclear. A similar picture has been reported in patients receiving high‐dose methotrexate (8–10 g/m2) for osteogenic sarcoma.

Original languageEnglish (US)
Pages (from-to)2003-2005
Number of pages3
JournalCancer
Volume54
Issue number9
DOIs
StatePublished - Nov 1 1984

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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