Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children

Taj, Mary M., Messahel, Boo, Mycroft, Julie, Pritchard-Jones, Kathy, Baker, Alistair, Height, Susan, Hadzic, Nedim and Pinkerton, C. Ross (2008) Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children. British Journal of Haematology, 140 2: 191-196. doi:10.1111/j.1365-2141.2007.06896.x


Author Taj, Mary M.
Messahel, Boo
Mycroft, Julie
Pritchard-Jones, Kathy
Baker, Alistair
Height, Susan
Hadzic, Nedim
Pinkerton, C. Ross
Title Efficacy and tolerability of high-dose methotrexate in central nervous system positive or relapsed lymphoproliferative disease following liver transplant in children
Journal name British Journal of Haematology   Check publisher's open access policy
ISSN 0007-1048
1365-2141
Publication date 2008-01
Sub-type Article (original research)
DOI 10.1111/j.1365-2141.2007.06896.x
Volume 140
Issue 2
Start page 191
End page 196
Total pages 6
Place of publication Oxford, United Kingdom
Publisher Blackwell
Language eng
Subject 1102 Cardiovascular Medicine and Haematology
Abstract Childhood post-transplant lymphoproliferative disease (PTLD) is a heterogeneous condition in which treatment varies, from the reduction of immunosuppression to moderately intensive chemotherapy. While low-dose chemotherapy/rituximab has been found to be effective, moderately intensive chemotherapy is required for patients who relapse, have classic non-Hodgkin lymphoma or have fulminant PTLD. Methotrexate (Mtx) is highly effective in lymphomas and crosses the blood-brain barrier. However, there are no data in the literature regarding its safety in post-liver transplant patients. We describe four cases of high-grade lymphomas (three diffuse large B cell and one T-cell lymphoblastic), post-liver transplant, for which chemotherapy including high-dose Mtx (HDMTX) was the treatment of choice. In total, 20 doses of HDMTX (1-5 g/m(2)) were given. The treatment was well tolerated and all four patients had a good response. One case of central nervous system (CNS) diffuse large B-cell lymphoma was treated with HDMTX alone. We conclude that, in the absence of significant organ damage, HDMTX can safely be given to liver transplant patients, but should only be administered in specialist oncology units. Proof of effectiveness as a single agent in CNS lymphoma needs further studies. ©2008 The Authors Journal Compilation © 2008 Blackwell Publishing Ltd
Keyword Childhood
Post-transplant lymphoproliferative disease
Highdose methotrexate
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 14 Jan 2010, 11:05:11 EST by Simon Utteridge on behalf of Faculty Of Health Sciences