Utilization and Outcomes of high dose Methotrexate in CNS lymphoma patients on hemodialysis; A report of 2 cases
Abstract
Patients with end stage renal disease usually do not receive high dose methotrexate therapy due to concerns for increased risk for adverse effects, including bone marrow suppression and mucositis. High dose methotrexate therapy is the standard of care for management of CNS lymphoma, both primary and secondary as well as for managing post-transplant lymphoproliferative disorders (PTLD) involving the CNS. These approaches have not been studied in ESRD, and there is growing interest in developing innovative strategies that enable safe high dose methotrexate (HDMTX) administration in patients with ESRD undergoing hemodialysis. We report the outcomes of two patients with primary CNS lymphoma (PCNSL) on HD who received high dose methotrexate with different dosing strategies. Both patients tolerated treatment well and continue to do well at follow up.
Key Points
Objective
This report aims to explore the safety and outcomes of high dose methotrexate in patients with CNS lymphoma on hemodialysis.
Methods
- Case report of two patients receiving high dose methotrexate treatment.
- Both patients monitored for adverse effects during therapy.
- Follow-up assessments were made to evaluate patient outcomes.
Results
- Both patients tolerated high dose methotrexate well without significant adverse effects.
- Continued to show positive health outcomes at follow-up visits.