Leukocytoclastic vasculitis and desensitization to high-dose methotrexate in primary central nervous system lymphoma

Publication date: Available online 19 March 2018 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Colette Hanna, Diego Villa, Carla Irani, Marwan Ghosn, Elie El Rassy The backbone drug in the management of primary central nervous system lymphoma (PCNSL) is systemic high-dose methotrexate (HD MTX). This case report describes a previously healthy 56-year old man diagnosed with PCNSL who developed a severe leucocytoclastic vasculitis that was clinically consistent with HD MTX toxicity. He was given a premedication regimen along with a desensitization protocol for HD MTX that permitted the administration of additional cycles of HD MTX without further serious adverse events. Ultimately, this case report highlights that it is possible to rechallenge patients with severe leucocytoclastic vasculitis with HD MTX provided that treatment modifications are introduced.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research