Methotrexate treatment protocols and the central nervous system: Significant cure with significant neurotoxicity

Avinoam Shuper, Batya Stark, Liora Kornreich, Ian J. Cohen, Shraga Aviner, Adam Steinmetz, Jeremiah Stein, Yaacov Goshen, Isaac Yaniv

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Methotrexate can influence the central nervous system through several metabolic toxic pathways. These effects can be categorized as immediate, acute to subacute, or chronic neurologic syndromes. The acute to subacute syndrome occurs frequently in acute lymphoblastic leukemia treatment protocols, generally manifesting with focal neurologic signs and changes seen on magnetic resonance imaging and single photon emission computed tomography. While in some patients the neurotoxicity is transient and benign and allows for continuation of chemotherapy, in others it can be quite severe and debilitating, leading to permanent neurologic deficits. The need to modify the treatment protocols when neurotoxicity appears is not fully established. It is also unknown whether the use of sufficient amounts of leucovorin can overcome the toxic effects of the drug.

Original languageEnglish
Pages (from-to)573-580
Number of pages8
JournalJournal of Child Neurology
Volume15
Issue number9
DOIs
StatePublished - 1 Jan 2000
Externally publishedYes

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