Intrathecal Chemotherapy Related Myelopathy Improved With Folate and Cyanocobalamin

ABSTRACT

Intrathecal chemotherapy with methotrexate and cytarabine arabinoside is used for the treatment and prophylaxis of malignancies, but can induce myelopathy. We report the case of a 50-year-old woman with stomach cancer who developed myelopathy after administration of intrathecal cytarabine arabinoside and methotrexate. The patient's neurologic status improved rapidly after the administration of folinate (15 mg) four times daily and cyanocobalamin (100 mug) once daily. The folate metabolites may be effective in the management of intrathecal-chemotherapy-induced myelopathy.