Adverse effects of intrathecal methotrexate in children with acute leukemia in remission.

摘要: A toxic syndrome characterized by fever, headache, and vomiting, lasting 2-5 days, occurred in 61% of 39 children with acute leukemia complete remission, receiving central nervous system prophylaxis intrathecal methotrexate, 14% 34 the same plus cranial radiation. The was accompanied pleocytosis lymphocytes, monocytoid cells, neutrophils. There evidence cumulative Mtx toxicity, since mostly after third fourth dose did not recur longer intervals between doses. incidence significantly reduced use Elliott's B solution as diluent, rather than water or normal saline. occurrence clinical also patients concomitant radiation, probably due to lympholytic action radiotherapy depressed cellular response irradiated tissues. diluent for IT an appropriate interval doses are suggested prevention this syndrome.