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Transient neurologic dysfunction following moderate‐dose methotrexate for undifferentiated lymphoma
Author(s) -
Martino Roy L.,
Benson Al B.,
Merritt James A.,
Brown Jeffrey J.,
Lesser John R.
Publication year - 1984
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19841101)54:9<2003::aid-cncr2820540936>3.0.co;2-r
Subject(s) - medicine , methotrexate , lymphoma , transient (computer programming) , anesthesia , computer science , operating system
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/m 2 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/m 2 ) for osteogenic sarcoma.