Rechallenging With Intrathecal Methotrexate After Developing Subacute Neurotoxicity in Children With Hematologic Malignancies

Colleen Badke, Amy Fleming, Asneha Iqbal, Ohmed Khilji, Sophia Parhas, Joanna Weinstein, Elaine Morgan, Nobuko Hijiya

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Methotrexate is associated with neurologic side effects. It is recommended that patients who developed neurotoxicity be rechallenged with methotrexate, but little is known about the safety of this approach. We performed a chart review to identify patients who received high-dose or intrathecal (IT) methotrexate. Twenty-one of 298 patients (7%) experienced neurologic symptoms attributed to methotrexate treatment in the premaintenance phase. Seventeen of these patients were rechallenged with IT methotrexate and 13 (76%) had no further neurotoxic events. No patients rechallenged during maintenance (n = 9) experienced recurrence of neurotoxic events. It is safe to rechallenge with IT methotrexate in maintenance.

Original languageEnglish (US)
Pages (from-to)723-726
Number of pages4
JournalPediatric Blood and Cancer
Issue number4
StatePublished - Apr 1 2016

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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