[High-dosage intralumbar methotrexate administration. A report on clinical experience]

In therapy and prophylaxis of meningeal leucemia, more than 400 injections of methotrexate, in doses between 15 mg and 50 mg (sometimes up to 75 mg) have been administered to 71 children without severe neurotoxic sequelae. This high dosage was applied repeatedly from 1970 to 1980 in 45 children suffering from acute lymphoblastic leucemia as CNS prophylaxis during a course of cobalt 60 irradiation of the skull. Since then primary CNS relapses have not been observed in these patients. The astonishing fact that these high intrathecal doses of methotrexate have been tolerated without adverse side effects may be attributed to the long intervals of at least 7 days between the individual applications.