Delayed recognition of intrathecal methotrexate overdose
Journal of Pediatric Hematology/Oncology, cilt.31, sa.5, ss.352-354, 2009 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 31 Sayı: 5
- Basım Tarihi: 2009
- Doi Numarası: 10.1097/mph.0b013e3181914709
- Dergi Adı: Journal of Pediatric Hematology/Oncology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.352-354
- Anahtar Kelimeler: acute lymphoblastic leukemia, children, intrathecal methotrexate, neurotoxicity, overdose
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
A 10-year-old girl who presented to our hospital was diagnosed as having B-precursor cell acute lymphoblastic leukemia. St Jude's Total XIII protocol was started. In the second block of the consolidation phase, 10 hours after triple intrathecal treatment, we realized that instead of 12mg, 120mg of methotrexate had accidentally been given. Although the patient had no symptoms 10 hours after intrathecal treatment, to prevent the possible neurotoxic effects of methotrexate, a cerebrospinal fluid exchange was performed. Simultaneously, systemic dexamethasone and calcium folinic acid were given. At the time of this writing (2y), the patient has had no symptoms and has continued on the chemotherapy protocol as planned. Administration of high-dose intrathecal methotrexate may not lead to symptoms, as was the case in our patient. This may be related to individual variations in cerebrospinal fluid dynamics and drug metabolism. © 2009 by Lippincott Williams & Wilkins.