Intrathecal Leucovorin After Intrathecal Methotrexate Overdose

@article{Jardine1996IntrathecalLA,
  title={Intrathecal Leucovorin After Intrathecal Methotrexate Overdose},
  author={Lisa Jardine and Liam Ingram and Werner A. Bleyer},
  journal={Journal of Pediatric Hematology/Oncology},
  year={1996},
  volume={18},
  pages={302–304}
}
Purpose: Intrathecal methotrexate is a standard and important therapy in acute leukemia. Unfortunately, overdose is a well reported complication of this therapy. We report a fatal event secondary to intrathecal leucovorin. Patients, Methods, and Results: An 11-year-old boy with a 6-month history of treatment of acute lymphocytic leukemia received an “overdose” of 20 mg of intrathecal methotrexate. He was treated with intrathecal leucovorin and subsequently experienced severe neurotoxicity and… 
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43 Citations
Background Citations
12
Methods Citations
1
Results Citations
1

43 Citations

Accidental High-dose Intrathecal Treatment: Late Results of a Patient
TLDR
A nursing error was experienced in which 35 mg of intrathecal methotrexate was administered instead of the planned 12 mg to a 3-year-old boy with T-cell non-Hodgkin lymphoma, stage IV, and his most recent cranial CT and electroencephalography results revealed no sequelae.
Emergency treatment of life-threatening intrathecal methotrexate overdose.
Accidental Overdose of Intrathecal Cytarabine in Children
TLDR
These cases demonstrate that measures such as CSF exchange are not uniformly required for cytarabine overdose, and are demonstrated to be safe and effective in children with cancer.
Successful treatment of intrathecal methotrexate overdose with folinic acid rescue: a case report
TLDR
The favourable outcome in a 7‐y‐old boy with acute lymphoblastic leukaemia suggests that folinic acid rescue may be adequate to prevent sequelae in patients who undergo intrathecal MTX overdoses up to 300 mg.
Intrathecal methotrexate neurotoxicity: clinical correlates and antidotal treatment.
Treatment of intrathecal methotrexate overdose with folinic acid rescue and lumbar cerebrospinal fluid exchange: A report of two cases.
TLDR
The favorable outcome in two male cases of intrathecal methotrexate overdose suggests that CSF exchange is safe and that folinic acid rescue may be adequate to prevent sequelae in patients subjected to intratheCal MTX overdoses up to 120 mg.
Treatment of two cases on the same day of intrathecal methotrexate overdose using cerebrospinal fluid exchange and intrathecal instillation of carboxypeptidase-G2
TLDR
Three years after the incident, one boy with acute lymphocytic leukemia has no neurological or neuropsychological sequelae after the MTX overdose, while the other reports some loss of short-term memory.
Delayed recognition of intrathecal methotrexate overdose.
TLDR
Administration of high-dose intrathecal methotrexate may not lead to symptoms, as was the case in a 10-year-old girl diagnosed with B-precursor cell acute lymphoblastic leukemia, but may be related to individual variations in cerebrospinal fluid dynamics and drug metabolism.
Successful use of intrathecal carboxypeptidase G2 for intrathecal methotrexate overdose: a case study and review of the literature.
Intrathecal methotrexate overdose
TLDR
Two children with acute lymphoblastic leukaemia and a 4‐y‐old boy with Burkitt's lymphoma who were to receive an intrathecal injection of methotrexate after completion of intravenous metotrexate infusion developed generalized convulsion 3 h after the overdose, but afterwards recovered completely.
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TLDR
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TLDR
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