Treatment of primary CNS lymphoma with high-dose methotrexate in immunocompetent pediatric patients

Pediatr Blood Cancer. 2010 Dec 1;55(6):1227-30. doi: 10.1002/pbc.22752.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Central Nervous System Neoplasms / drug therapy*
  • Central Nervous System Neoplasms / immunology
  • Central Nervous System Neoplasms / pathology
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Immunocompetence
  • Infant
  • Lymphoma, B-Cell / drug therapy*
  • Lymphoma, B-Cell / immunology
  • Lymphoma, B-Cell / pathology
  • Lymphoma, Large-Cell, Anaplastic / drug therapy*
  • Lymphoma, Large-Cell, Anaplastic / immunology
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Male
  • Methotrexate / therapeutic use*
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate