Successful Treatment of Osteosarcoma Without Methotrexate in a 13-Year-Old Boy With Down SyndromeSims, Emma, BS; Nath, Audrey, MD, PhD; Sugalski, Aaron, DOJournal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p 71–73 doi: 10.1097/MPH.0000000000001212 Clinical and Laboratory Observations Abstract Author InformationAuthors Article MetricsMetrics Osteosarcoma is the most common primary bone tumor in children, and only 1 article in the literature describes a case of osteosarcoma in a patient with Down syndrome. Although osteosarcoma is generally treated with chemotherapy regimens that include high-dose methotrexate, patients with Down syndrome have heightened sensitivity to the toxicities of methotrexate. The patient from the aforementioned case study died from sepsis soon after treatment with high-dose methotrexate. This case report describes the successful treatment of osteosarcoma in a pediatric patient with Down syndrome without methotrexate. Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX The authors declare no conflict of interest. Reprints: Aaron Sugalski, DO, Department of Pediatrics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MS 7810, San Antonio, TX 78229 (e-mail: firstname.lastname@example.org). Received July 19, 2017 Accepted April 17, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.