Abstract
In general, the intraventricular administration of cytotoxic antitumor drugs provides a high drug concentration in the cerebrospinal fluid with a reduced risk of systemic adverse reactions. Methotrexate (MTX) high-dose therapy requires close monitoring when performed in combination with trimethoprim-sulfamethoxazole (ST) therapy and proton pump inhibitor (PPI) and nonsteroidal anti-inflammatory drug administration for excretion delay and toxicity enhancement. While the frequency of systemic side effects is thought to be low with intrathecal administration, such effects do rarely but occasionally occur. We must consider drug interactions with combination therapy as a potential factor inducing such effects. We examined the patients who received MTX intrathecal administration at Fukuoka University Hospital from January 2013 to December 2014 with respect to the onset of side effects and combination therapy. MTX intrathecal administration was performed a total of 79 times in 27 patients. In five of these 27 patients, MTX intrathecal administration was performed twice a week, and hematotoxicity and non-hematotoxicity developed in two patients in whom ST was also administered. On the other hand, even if ST and/or PPI was administered,...Continue Reading
References
Aug 1, 1989·Annals of Internal Medicine·M E JeurissenL B van de Putte
Feb 2, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·H M KantarjianE J Freireich
Jul 3, 2002·Leukemia·J TakeuchiR Ohno
Aug 15, 2002·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A HollenderH Holte
Dec 31, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·E ZuccaUNKNOWN International Extranodal Lymphoma Study Group
Nov 3, 2005·Leukemia & Lymphoma·Janessa J LaskinJoseph M Connors
Dec 14, 2006·Annals of Oncology : Official Journal of the European Society for Medical Oncology·H-T ArkenauA Horwich
May 27, 2008·Blood·Wendy StockUNKNOWN Cancer and Leukemia Group B studies
Dec 3, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Steven H BernsteinRichard I Fisher
Dec 17, 2008·British Journal of Clinical Pharmacology·Kunihiro SuzukiYukinao Kohda
Jan 7, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Françoise HuguetHervé Dombret
Apr 9, 2009·International Journal of Hematology·Yutaka ShimazuYasunori Ueda
Oct 29, 2009·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D VillaK J Savage
Jun 27, 2012·Blood·Robert E GallagherWendy Stock
Apr 17, 2014·The Journal of Rheumatology·Beverley SheaPeter Tugwell