Intrathecal methotrexate(MTX): Complications
High dose & intrathecal Methotrexate (MTX) is often used for consolidation and CNS relapse prevention because it has been reported to improve the outcome of ALL therapy. However, MTX has side effects such as inhibition of myelin synthesis, antisera, oligodendrocytes, and BBB function. The most serious side effect of MTX is neurotoxicity, which may cause a side effect of up to 3-15% of the total treated patients, which may be transient, but may require occasional coma or death. Subacute effects can be divided into acute, subacute, and chronic neurotoxicity syndromes depending on the time that side effects occur due to IV and IT use. Acute-phase side effects include somnolence, confusion, headache, nausea, vomiting, and dizziness within several hours after IV administration of high-dose chemical meningitis and within several hours after ITx MTX treatment. Chronic side effects appear within a few months after MTX administration, and symptoms such as cognitive decline, abnormal behavi...