Abstract | PURPOSE: PATIENTS AND METHODS: In this retrospective analysis, we used high-performance liquid chromatography (HPLC) to measure Hcy, HCA, and CSA in CSF from two groups of children: (1) a control group of patients with no MTX exposure, and (2) a treatment group of patients who had received MTX no more than 7 days before a scheduled lumbar puncture. RESULTS: The treatment group had a significantly (P = .0255) greater concentration of Hcy in CSF (0.814 micromol/L +/- 0.215 [mean +/- SEM], n = 23) than the control group (0.210 micromol/L +/- 0.028, n = 34). HCA and CSA were not detected in CSF from control patients (n = 29); however, MTX caused marked accumulation of CSF HCA (119.1 micromol/L +/- 32.0, n = 16) and CSA (28.4 micromol/L +/- 7.7, n = 16) in the treatment group. Patients with neurologic toxicity at the time of lumbar puncture had many of the highest concentrations of Hcy, HCA, and CSA. CONCLUSION: These data support our hypothesis that MTX-associated neurotoxicity may be mediated by Hcy and excitotoxic neurotransmitters.
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Authors | C T Quinn, J C Griener, T Bottiglieri, K Hyland, A Farrow, B A Kamen |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 15
Issue 8
Pg. 2800-6
(Aug 1997)
ISSN: 0732-183X [Print] United States |
PMID | 9256122
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antimetabolites, Antineoplastic
- Excitatory Amino Acids
- Neurotransmitter Agents
- Homocysteine
- homocysteic acid
- Cysteine
- cysteine sulfinic acid
- Methotrexate
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Topics |
- Antimetabolites, Antineoplastic
(adverse effects, therapeutic use)
- Central Nervous System
(drug effects)
- Child
- Chromatography, High Pressure Liquid
- Cysteine
(analogs & derivatives, cerebrospinal fluid)
- Excitatory Amino Acids
(cerebrospinal fluid)
- Homocysteine
(analogs & derivatives, cerebrospinal fluid)
- Humans
- Methotrexate
(adverse effects, therapeutic use)
- Neoplasms
(cerebrospinal fluid, drug therapy)
- Neurotransmitter Agents
- Retrospective Studies
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