Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Pediatr Blood Cancer. 2015 Mar;62(3):539-41. doi: 10.1002/pbc.25270. Epub 2014 Oct 31.
Systemic and intrathecal methotrexate is widely used in treatment protocols for childhood acute lymphoblastic leukemia. Its side effects vary in characteristics, intensity and time of onset, and depend on the administration route. Interactions with several drugs are known. Side effects of nitrous oxide sedation, often used for moderately painful procedures, typically occur after long time use and include neurological symptoms. We present a child who experienced a severe and long-lasting neurotoxicity after the third intrathecal application of methotrexate with short sedation by nitrous oxide during induction therapy for acute lymphoblastic leukemia. Symptoms completely resolved after 12 months.
甲氨蝶呤的全身和鞘内给药被广泛用于儿童急性淋巴细胞白血病的治疗方案中。其副作用在特征、强度和发病时间上各不相同，并且取决于给药途径。已知与几种药物存在相互作用。通常在长时间使用后才会出现用于中度疼痛处理的一氧化二氮镇静的副作用，包括神经系统症状。我们报告了 1 例儿童在急性淋巴细胞白血病诱导治疗期间接受短暂的一氧化二氮镇静后，在第 3 次鞘内应用甲氨蝶呤后出现严重且持久的神经毒性。12 个月后症状完全缓解。
