Aminophylline for methotrexate-induced neurotoxicity

@article{Bernini1995AminophyllineFM,
  title={Aminophylline for methotrexate-induced neurotoxicity},
  author={Juan Carlos Bernini and Daniel W. Fort and James C Griener and Bonnie J. Kane and W. B. Chappell and Barton A. Kamen},
  journal={The Lancet},
  year={1995},
  volume={345},
  pages={544-547}
}
Methotrexate, a mainstay treatment for children with acute lymphoblastic leukaemia, can cause neurotoxicity, with paralysis, seizures, somnolence, anorexia, and headaches. The pathophysiology of this reaction is unknown. It has been suggested that the anti-inflammatory effect of methotrexate in patients with arthritis is due to adenosine release brought on by inhibition of purine synthesis. Since adenosine is a central nervous system depressant, we wondered whether adenosine release in the… Expand
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References

SHOWING 1-10 OF 26 REFERENCES
Cytarabine and neurologic toxicity.
  • W. Baker, G. Royer, R. Weiss
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1991
TLDR
A better understanding of the pathophysiology and pharmacology of such cytarabine-induced neuronal injury will allow this drug to be used with greater efficacy and safety. Expand
Pentostatin: An Adenosine Deaminase Inhibitor for the Treatment of Hairy Cell Leukemia
TLDR
Pentostatin is a purine analog that inhibits adenosine deaminase, a key enzyme necessary for purine salvage and will be a useful addition to the therapeutic agents presently available to patients with HCL. Expand
Neurotoxicity due to central nervous system therapy for childhood leukemia.
  • J. Ochs
  • Medicine
  • The American journal of pediatric hematology/oncology
  • 1989
TLDR
With more aggressive, and hence more effective, prophylaxis with intrathecal methotrexate, spinal cord myelopathy may become a significant new area of neurotoxicity. Expand
Neurologic sequelae of methotrexate and ionizing radiation: a new classification.
  • W. Bleyer
  • Medicine
  • Cancer treatment reports
  • 1981
TLDR
This article attempts to categorize the types of neurotoxicities reported in patients treated with methotrexate (MTX) and ionizing radiation, and concludes that combinations including CNS irradiation appear to be the most neurotoxic. Expand
Intermediate-dose intravenous methotrexate and mercaptopurine therapy for non-T, non-B acute lymphocytic leukemia of childhood: a Pediatric Oncology Group study.
TLDR
Assured (parenteral) delivery of higher doses of MTX and MP should maximize tissue levels of these drugs by overcoming individual variations in absorption, metabolism, clearance, and compliance. Expand
Folate and methotrexate polyglutamate tissue levels in rhesus monkeys following chronic low-dose methotrexate.
TLDR
To better define the effects of chronic MTX treatment, tissue levels of MTX, MTXGlun, and folate were measured in three monkeys treated with weekly intramuscular MTX for 1 year and greater than 80% of the total tissue MTX found was in the form of polyglutamated derivatives. Expand
The antiinflammatory mechanism of methotrexate. Increased adenosine release at inflamed sites diminishes leukocyte accumulation in an in vivo model of inflammation.
TLDR
Results indicate that methotrexate is a nonsteroidal antiinflammatory agent, the antiphlogistic action of which is due to increased adenosine release at inflamed sites. Expand
Chronic neurologic disturbance in childhood leukemia
TLDR
Three school‐aged children have learning disability and perceptual‐motor defects and studies of CSF folate and MTX content are presented but are not helpful in delineating the etiology of these neurologic symptoms. Expand
Long-term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis. Update after a mean of 90 months.
TLDR
It is concluded that a majority of rheumatoid arthritis patients are able to continue MTX treatment with generally sustained efficacy, for intervals that meaningfully exceed those reported previously. Expand
Effects of methotrexate on astrocytes in primary culture: light and electron microscopic studies
TLDR
It is shown that pure populations of astrocytes can be adversely affected by MTX especially in the absence of bBcAMP, while also causing reactive-like changes in some cells. Expand
...
1
2
3
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