Document Detail


Concurrent administration of intravenous systemic and intravitreal methotrexate for intraocular lymphoma with central nervous system involvement.
MedLine Citation:
PMID:  20464643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intraocular lymphoma (IOL) is rare lymphoma that frequently infiltrates the central nervous system (CNS). An optimal treatment has not been established, and its prognosis is quite poor. We treated three IOL patients with CNS involvement by concurrent administration of intravenous and intravitreal methotrexate (MTX) injection. The intraocular lesion responded in all patients. One patient achieved complete response (CR), whereas the other 2 patients were in partial response for CNS lesion, added whole brain radiation and achieved CR. In 3 eyes of 2 patients, an intravitreal MTX injection (vMTX) was administered 2 h after a systemic MTX injection (sMTX) and the intravitreal MTX concentration was measured twice: 2 h after sMTX and 24 h after vMTX. The half-life of MTX in the vitreous fluid was estimated to be 12.4-21.5 h by assuming the first-order elimination kinetics. Although the concentration was still high 24 h after vMTX (69.94-82.89 muM), there were no ocular complications. The serum MTX concentration was not influenced by adding vMTX to sMTX. Grade 3 adverse event, leukocytopenia, was observed in only 1 patient. No grade 4 event was observed. Although further evaluation is required, concurrent sMTX and vMTX may be effective for IOL with CNS involvement.
Authors:
Yusuke Nakauchi; Hiroshi Takase; Sunao Sugita; Manabu Mochizuki; Satoko Shibata; Yasuyoshi Ishiwata; Yuka Shibuya; Masato Yasuhara; Osamu Miura; Ayako Arai
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-05-13
Journal Detail:
Title:  International journal of hematology     Volume:  92     ISSN:  1865-3774     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-85     Citation Subset:  IM    
Affiliation:
Department of Hematology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyoku, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antimetabolites, Antineoplastic
Central Nervous System Neoplasms / drug therapy
Drug Administration Routes
Eye Neoplasms / drug therapy*,  pathology
Female
Humans
Lymphoma, Non-Hodgkin / drug therapy*,  pathology
Methotrexate / administration & dosage*
Middle Aged
Neoplasm Invasiveness
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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