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Clinico-radiological profile, management and follow-up of methotrexate induced neurotoxicity in children with acute lymphoblastic leukemia.
Dhariwal, Nidhi; Roy Moulik, Nirmalya; Smriti, Vasundhara; Dhamne, Chetan; Chichra, Akanksha; Srinivasan, Shyam; Narula, Gaurav; Banavali, Shripad.
Afiliación
  • Dhariwal N; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
  • Roy Moulik N; Homi Bhabha National Institute, Mumbai, India.
  • Smriti V; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
  • Dhamne C; Homi Bhabha National Institute, Mumbai, India.
  • Chichra A; Homi Bhabha National Institute, Mumbai, India.
  • Srinivasan S; Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India.
  • Narula G; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
  • Banavali S; Homi Bhabha National Institute, Mumbai, India.
Leuk Lymphoma ; 64(12): 1971-1980, 2023 12.
Article en En | MEDLINE | ID: mdl-37565568
Methotrexate-induced neurotoxicity is a well-defined side-effect of high-dose and intrathecal methotrexate with characteristic clinico-radiological findings and transient nature. Our experience in managing this entity in children with acute lymphoblastic leukemia(ALL) is reported here. All children with de novo ALLregistered from January 2016 through December 2021 who developed methotrexate-induced neurotoxicity were included. Of children with ALL treated during the study period, thirty-three experienced methotrexate induced neurotoxicity with an incidence of 1.25%. Stroke-like symptoms(36.36%; 12/33) were the most common clinical manifestation followed by seizures(30.3%, 10/33). Twenty-three patients had radiological features consistent with methotrexate-induced leukoencephalopathy. With emerging evidence, thirty-one patients were re-challenged with methotrexate (IV/IT), of whom 4 patients had recurrence of symptoms. No long-term neurological sequalae were noted in our cohort, despite rechallenging. Therefore in our study, methotrexate induced neurotoxicity is a self-limiting toxicity and methotrexate can be re-challenged safely without compromising theintensity of CNS-directed therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metotrexato / Síndromes de Neurotoxicidad / Leucemia-Linfoma Linfoblástico de Células Precursoras / Leucoencefalopatías Límite: Child / Humans Idioma: En Revista: Leuk Lymphoma Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metotrexato / Síndromes de Neurotoxicidad / Leucemia-Linfoma Linfoblástico de Células Precursoras / Leucoencefalopatías Límite: Child / Humans Idioma: En Revista: Leuk Lymphoma Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos