Treatment of primary CNS lymphoma with high-dose methotrexate in immunocompetent pediatric patients.
We report two cases of primary CNS lymphoma (PCNSL) treated with high-dose methotrexate. Though standard adult treatment of PCNSL incorporates whole-brain radiotherapy, the literature suggests it may be possible to delay or avoid radiotherapy and the associated increased risk of neurologic sequelae in pediatric patients. Studies in adults indicate methotrexate therapy can be effective against PCNSL and has advantages over the current standard of treatment. Both patients have no evidence of disease 9 and 7 years after treatment, suggesting high-dose methotrexate may lead to disease control in pediatric patients with PCNSL while avoiding the effects of radiotherapy.
Shah
Amish C
AC
Department of Pediatrics, Children's Hospital of Philadelphia, Pennsylvania, Philadelphia, USA.
Kelly
David R
DR
Nabors
L Burt
LB
Oakes
W Jerry
WJ
Hilliard
Lee M
LM
Reddy
Alyssa T
AT
D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate