Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

High-dose methotrexate in childhood all.

P J Moe1, A Holen

  • 1Children Hospital, Regionsykehuset i Trondheim, Trondheim, Norway.

Pediatric Hematology and Oncology
|December 29, 2000
PubMed
Summary

High-dose methotrexate effectively prevents central nervous system (CNS) relapse in acute lymphocytic leukemia (ALL) children, offering an alternative to cranial irradiation and its associated neurotoxicities.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Anxiety and Depression during COVID-19 Pandemic among Medical Students in Nepal.

Kathmandu University medical journal (KUMJ)·2021
Same author

Impact factor of medical education journals and recently developed indices: Can any of them support academic promotion criteria?

Journal of postgraduate medicine·2016
Same author

Can we rely on simulated patients' satisfaction with their consultation for assessing medical students' communication skills? A cross-sectional study.

BMC medical education·2015
Same author

Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS).

Kathmandu University medical journal (KUMJ)·2015
Same author

Measuring Neuroticism in Nepali: Reliability and Validity of the Neuroticism Subscale of the Eysenck Personality Questionnaire.

Kathmandu University medical journal (KUMJ)·2015
Same author

Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey.

Kathmandu University medical journal (KUMJ)·2015

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Neuro-oncology

Background:

  • Acute lymphocytic leukemia (ALL) survival rates are high, but long-term therapy side effects remain a challenge.
  • Cranial irradiation, once standard for CNS prophylaxis in ALL, is linked to secondary malignancies and neurotoxicities.
  • Methotrexate-based chemotherapy is now preferred for CNS prophylaxis in ALL.

Purpose of the Study:

  • To evaluate the efficacy and safety of high-dose methotrexate for central nervous system (CNS) prophylaxis in acute lymphocytic leukemia (ALL).
  • To compare methotrexate-based CNS prophylaxis with cranial irradiation in pediatric ALL patients.

Main Methods:

  • Review of historical and recent ALL treatment protocols focusing on CNS prophylaxis strategies.
  • Analysis of data from studies utilizing intermediate and high-dose methotrexate (intrathecal and intravenous) for CNS prophylaxis.
  • Comparison of CNS relapse rates and neurotoxicity profiles between methotrexate and cranial irradiation groups.

Main Results:

  • High-dose methotrexate (5-8 g/m2) combined with intrathecal administration significantly reduces CNS relapse rates in ALL.
  • Studies show CNS relapse rates as low as 2.2% with high-dose methotrexate, compared to historical rates with irradiation.
  • High-dose methotrexate, when irradiation is avoided, is associated with manageable adverse effects like mucositis and myelosuppression, unlike the neurotoxicities of cranial irradiation.

Conclusions:

  • High-dose methotrexate is a safe and effective alternative to cranial irradiation for CNS prophylaxis in pediatric ALL.
  • Methotrexate-based regimens minimize long-term neurotoxicities and secondary malignancies associated with cranial irradiation.
  • Careful monitoring and supportive care, including folinic acid rescue, are crucial for managing methotrexate therapy.

Related Experiment Videos