Methotrexate-induced subacute myelopathy: a serious but treatable complication.
J Clin Exp Hematop
; 63(4): 251-256, 2023.
Article
in En
| MEDLINE
| ID: mdl-38148015
ABSTRACT
Subacute myelopathy is a rare but serious complication of methotrexate (MTX) that may cause paraplegia. Although its underlying mechanisms have not been fully elucidated, homocysteine is thought to play a role in the pathogenesis of this adverse effect. Herein, we report the case of a 34-years old female patient with diffuse large B-cell lymphoma who developed progressive paraplegia accompanied by dysfunctional bladder and bowel movements after treatment with a modified CODOX-M/IVAC regimen, including high-dose intravenous MTX and intrathecal (IT-) MTX. Neurological symptoms gradually improved to almost normal levels within 4.5 months of onset following treatment with a combination of S-adenosylmethionine, methionine, cyanocobalamin, and folate. During chemotherapy, including high-dose MTX and IT-MTX for hematological malignancies, MTX-induced subacute neuronal damage should be carefully evaluated, and appropriate treatment should be initiated as early as possible.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Diseases
/
Bone Marrow Diseases
/
Lymphoma, Large B-Cell, Diffuse
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
J Clin Exp Hematop
/
J. clin. exp. hematop. (Online)
/
Journal of clinical and experimental hematopathology (Online)
Journal subject:
HEMATOLOGIA
/
PATOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Japón
Country of publication:
Japón