International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 163-165
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Intrathecal Methotrexate and Acute Neurotoxicity: A Painful Experience
Akif ALTINBAŞ1, Şafak ÇAVUŞ1, Ebru KOCA2, Deniz ÇETİNER2, Ali SHORBAGI1, İbrahim C. HAZNEDAROĞLU1
1Hacettepe University, Faculty of Medicine, Department of Internal Medicine, ANKARA
2Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, ANKARA
Keywords: Intrathecal methotrexate, Central nervous system involvement, Acute neurotoxicity, Acute lymphoblastic leukemia
Intrathecal treatment with methotrexate, an essential chemotherapeutic for both prophylaxis and treatment of central nervous system involvement of leukemia, may be associated with local neurotoxicity and/or systemic toxicity. Signs of acute neurotoxicity include confusion, disorientation, seizures, aphasia, ataxia, dysarthria, paresis and even paralysis. Presented here is a case of a 58 year old patient with acute lymphoblastic leukemia who developed acute neurotoxicity after her 13th dose of intrathecal methotrexate. Available treatment options are also discussed.
Akif ALTINBAŞ1, Şafak ÇAVUŞ1, Ebru KOCA2, Deniz ÇETİNER2, Ali SHORBAGI1, İbrahim C. HAZNEDAROĞLU1
1Hacettepe University, Faculty of Medicine, Department of Internal Medicine, ANKARA
2Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, ANKARA
Keywords: Intrathecal methotrexate, Central nervous system involvement, Acute neurotoxicity, Acute lymphoblastic leukemia
Intrathecal treatment with methotrexate, an essential chemotherapeutic for both prophylaxis and treatment of central nervous system involvement of leukemia, may be associated with local neurotoxicity and/or systemic toxicity. Signs of acute neurotoxicity include confusion, disorientation, seizures, aphasia, ataxia, dysarthria, paresis and even paralysis. Presented here is a case of a 58 year old patient with acute lymphoblastic leukemia who developed acute neurotoxicity after her 13th dose of intrathecal methotrexate. Available treatment options are also discussed.
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