Anaphylactoid type reactions in two patients receiving high dose intravenous methotrexate

Two patients recieving intravenous high dose methotrexate (MTX) and intracutaneous BCG injections as adjuvant treatment for osteogenic sarcoma suffered sudden cardiovascular collapse within minutes of infusion of MTX. These cases demonstrate that anaphylactic or idiosyncratic reactions to MTX and/or contaminants in these preparations do occur and that careful patient monitoring is required.