Skip Navigation LinksHome > January 2014 - Volume 36 - Issue 1 > Correlating Pathology With the Clinical Symptoms of Methotre...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e31827b6adb
Online Articles: Clinical and Laboratory Observations

Correlating Pathology With the Clinical Symptoms of Methotrexate-induced Leukoencephalopathy in a Child With Relapsed T-cell Acute Lymphoblastic Leukemia

Summers, Ryan J. MD*; Abramowsky, Carlos R. MD*,†; Cooper, Todd M. DO*,‡

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Abstract

Intrathecal and systemic methotrexate (MTX), as well as cranial radiation, are effective modalities to prevent central nervous system relapse in childhood acute lymphoblastic leukemia. Leukoencephalopathy is a well-described adverse effect of MTX therapy and is associated with a wide range of neurological sequelae. Most recent studies of MTX-induced leukoencephalopathy have focused exclusively on imaging findings, particularly magnetic resonance imaging. Here we report a case of severe MTX-induced leukoencephalopathy with unique magnetic resonance imaging findings and pathologic correlation from a brain biopsy taken during a period of active neurological symptomatology.

© 2014 by Lippincott Williams & Wilkins.

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