Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper describes the case history of a 43 year-old patient with so-called primary reticulum cell sarcoma of the brain. The CSF contained cells suggestive of leukaemia which in view of an assumed myelofibrosis, initially seemed also possible to originate from a haematopoietic focus. The patient complained of intermittent violent headaches, which were controlled by spinal taps to release highly cellularised CSF under high pressure and by intrathecal MTX injection, every 4-6 weeks over a period of 4.5 years. In the terminal stage the patient developed paraplegia which, partly on the basis of neuropathological findings, was ascribed to the large accumulated dose of MTX. The tumour proved to be localised in the fornix; the localisation adjacent to the ventricular system made the intermittent cell eruptions in the CSF possible. On the basis of an erroneous diagnostic assumption, a therapy was instituted which resulted in a survival of 6.5 years, which is exceptionally long for a patient with 'primary reticulum cell sarcoma' of the brain.
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PMID:A patient with so-called primary reticulum cell sarcoma of the brain with 6.5 years' survival, treated as 'meningeal leukaemia'. 80 Sep 69

The kinetics and distribution of methotrexate in intraventricular and intrathecal cerebrospinal-fluid spaces were studied in patients with meningeal leukemia and meningeal carcinomatosis after drug administration by intravenous infusion, indwelling intraventricular subcutaneous reservoir (Ommaya), or standard lumbar puncture. Negligible ventricular concentrations followed a single intravenous dose. During an intravenous infusion (500 mg per square meter for 24 hours) the ventricular cerebrospinal-fluid concentration rose to 6 times 10-minus 7 M. Methotrexate administered by Ommaya reservoir, at a dose of 6.25 mg per square meter, rapidly distributed in the subarachnoid space; the peak ventricular concentration of 2 times 10-minus 4 M declined exponentially over 48 hours. Lumbar cerebrospinal-fluid concentration reached a maximum of 5 times 10-minus 5 M four hours after injection and then fell exponentially. Administration by lumbar puncture occasionally produced epidural and subdural leakage; even with successful lumbar puncture, ventricular methotrexate concentration varied considerably from patient to patient despite similar doses. Administration by Ommaya reservoir more reliably produced adequate cerebrospinal fluid distribution than administration by lumbar puncture.
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PMID:Methotrexate: distribution in cerebrospinal fluid after intravenous, ventricular and lumbar injections. 80 16

Multiple fractures occurred in 7 children treated with methotrexate for leukemia. Non-union or delayed union in spite of adequate immobilization also occurred in children on methotrexate. When the methotrexate was discontinued the fractures usually healed. Methotrexate appears to be a drug which inhibits osteogenesis, and may be promising in heterotopic ossification and related orthopedic conditions.
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PMID:Fractures in children treated with methotrexate for leukemia. 88 Jul 55

The killing of the LR subline of the DBA/2J leukemia L1210/MTX by passive antibody was followed in vivo with 131I-iododeoxyuridine-labeled cells and whole-body measurement of retained radioactivity. The in vivo killing of LR cells was proportional to the in vitro 2-mercaptoethanol resistant titer, independent of the complement system, and radioresistant. Although a large percentage of the leukemic cells was killed in passively immunized mice, the protective effect of the passive antiserum was dependent on the active immune response of the host.
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PMID:Antibody-induced killing in vivo of L1210/MTX-R cells quantitated in passively immunized mice with 131I-iododeoxyuridine-labeled cells and whole-body measurement of retained radioactivity. 95 54

Methotrexate, tetracycline, gentamicin, streptomycin, and penicillin inhibited the growth of L5178Y murine leukemia cells in culture with I(50) (concentration of drug that caused a 50% inhibition of growth at 72 h) values of 0.0028 mug/ml (6.2 x 10(-9) M), 7.9 mug/ml, 200 mug/ml, 1,700 mug/ml, and 3,000 mug/ml (5,000 U/ml), respectively. At concentrations achieved clinically or utilized in the laboratory, the antibiotics did not alter the I(50) of methotrexate.
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PMID:Inhibition of L5178Y cells in culture by methotrexate and antibiotics. 98 51

Experience with CNS prophylaxis in 35 children with acute lymphatic leukaemia is reported. Before prophylactic irradiation of the skull was given the average survival time in 36 children was 2,8 (2,7) years. Menigeal leukaemia preceeded bone marrow relapse in 9 cases and followed relapse in a further 5 cases (39%). Between 1971 and 1973 Pinkel's treatment scheme VII was given to 35 children. This included prophylactic skull irradiation and intraspinal MTX injections. 29 children are still in their first remissions which range from 10 - 35 months in length. Meningeal leukaemia has not so far been observed, in this latter group.
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PMID:Prevention of meningeal leukaemia and relapses by cranial irradiation and intrathecal MTX in acute lymphatic leukaemia. 105 42

During maintenance therapy with intraventricular methotrexate, progressive dementia developed in a child with meningeal leukemia. Cerebrospinal fluid levels of MTX were in the nontoxic range and neurologic evaluation failed to demonstrate anatomic obstruction, infection, or folate depletion. The patient's symptoms gradually resolved when the methotrexate was discontinued, suggesting that methotrexate neurotoxicity may occur in the absence of an elevated CSF concentration of MTX.
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PMID:Reversible dementia temporally associated with intraventricular therapy with methotrexate in a child with acute myelogenous leukemia. 106 Jul 45

A pharmacokinetic study of methotrexate levels in blood and cerebrospinal fluid was performed in 42 patients who received one or more courses of high-dose methotrexate at 500 mg/sq m infused i.v. over a 24-hr period. Methotrexate level in the lumbar cerebrospinal fluid reached 1.2 x 10(-7) M at 0.5 hr and remained constant at that level for the 1st 24 hr. Similar methotrexate levels were noted in the ventricular fluid obtained through an Ommaya device on three patients with brain tumors treated with high doses of methotrexate. Preliminary clinical results using high-dose methotrexate combined with simultaneous intrathecal methotrexate in 23 children with newly diagnosed acute lymphocytic leukemia indicate that this treatment program is safe to administer and to date appears effective in the prevention of central nervous system leukemia.
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PMID:Treatment of acute lymphocytic leukemia by high-dose intravenous methotrexate. 106 65

The author describes a 20-year-old patient with leukaemia and with meningoradicular symptoms. The first neurological symptoms developed 2 years after disclosure of haematological changes. Despite treatment with steroids, intrathecal Methotrexate and radiotherapy the patient died 3 years after the diagnosis of leukaemia had been established. Myeloblastic leukaemia was confirmed on autopsy. The importance of early intrathecal Methotrexate treatment is stressed.
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PMID:[Diagnostic difficulties in a case of leukemia with radicular symptoms]. 106 49

A protocol for the prophylaxis of CNS leukemia was devised involving intermittent low-dosage radiation of the craniospinal axis combined with single intrathecal injections of MTX. The retionale for this protocol was the timing of first CNS relapses in patients not receiving prophylaxis which suggests that leukemic colonization of the CNS is not restricted to the initial stage of the disease and that periodic measures might be advantageous. The low dosage of radiation was chosen because it is well tolerated and has been found temporaily effective in overt CNS relapse. The two series of patients were comparable as to various parameters. Results after three years of observation were comparable to those obtained by other with a single initial course of high-dose radiation, with an expected 50% uninterrupted complete 5-year remission. On the basis of 30 months follow up in 26 patients, the therapy is well tolerated. An increase in morbidity due to infections in remission was not associated with a higher mortality.
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PMID:IMFRA (intermittent intrathecal methotrexate and fractional radiation) plus chemotherapy in childhood leukemia. 106 74


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