Methotrexate-Induced Neurotoxicity in Paediatric Malignancies

Abstract

Hematologic malignancies have a growing variety of therapeutic options, but many of these have both central and peripheral nervous system side effects, which may force the physician to discontinue or lower the dosage of the offending drug to prevent irreversible damage. Neurotoxicity is a common side effect of chemotherapy. Peripheral neuropathy is frequent with many medicines, but other complications such as seizures and encephalopathy may require immediate intervention. Early detection of undesirable neurological side effects may lead to more effective treatments and dosage changes. Furthermore, understanding typical toxicities may aid in distinguishing chemotherapy-related symptoms from cancer progression into the CNS. In this article, we discuss the potential side effects of Methotrexate use in childhood hematologic malignancies, with a focus on the difficulty of the differential diagnosis of newly onset neurological symptoms in pediatric oncology patients and potential interventions.