Am J Blood Res 2012;2(1):66-70
Brief Communication
High dose methotrexate and extended hours high-flux hemodialysis for the
treatment of primary central nervous system lymphoma in a patient with end
stage renal disease
Howard Mutsando, Magid Fahim, Devinder S Gill, Carmel M Hawley, David W Johnson, Maher K Gandhi, Paula V Marlton,
Helen G Mar Fan, Peter N Mollee
Haematology Department, Princess Alexandra Hospital, Brisbane, Australia; Department of Nephrology, Princess Alexandra
Hospital, Brisbane, Australia; Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; University
of Queensland School of Medicine, Brisbane, Australia
Received November 3, 2011; accepted December 1, 2011; Epub December 15, 2011; Published January 15, 2012
Abstract: This report discusses the case of a 52 year old female with post-transplant lymphoproliferative disorder, confined to
the central nervous system, which was managed with high dose methotrexate (HDMTX) in the context of end stage renal
disease. The patient received two doses of HDMTX followed by extended hours high-flux hemodialysis, plasma methotrexate
concentration monitoring and leucovorin rescue. The hemodialysis technique used was effective in clearing plasma
methotrexate and allowed delivery of HDMTX to achieve complete remission with limited and reversible direct
methotrexate-related toxicity. Dialysis-dependent renal failure does not preclude the use of HDMTX when required for curative
therapy of malignancy. (AJBR11110001).
Keywords: High dose methotrexate, end stage renal disease, dialysis, primary central nervous system lymphoma,
post-transplant lymphoproliferative disorder
Full Text PDF
Address all correspondence to:
Peter Mollee
Department of Haematology, Pathology Queensland
Princess Alexandra Hospital,
Ipswich Rd, Woolloongabba 4102,
Australia.
Tel: +61 7 32402396
Fax: +61 7 34207042
E-mail: peter_mollee@health.qld.gov.au
Brief Communication
High dose methotrexate and extended hours high-flux hemodialysis for the
treatment of primary central nervous system lymphoma in a patient with end
stage renal disease
Howard Mutsando, Magid Fahim, Devinder S Gill, Carmel M Hawley, David W Johnson, Maher K Gandhi, Paula V Marlton,
Helen G Mar Fan, Peter N Mollee
Haematology Department, Princess Alexandra Hospital, Brisbane, Australia; Department of Nephrology, Princess Alexandra
Hospital, Brisbane, Australia; Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; University
of Queensland School of Medicine, Brisbane, Australia
Received November 3, 2011; accepted December 1, 2011; Epub December 15, 2011; Published January 15, 2012
Abstract: This report discusses the case of a 52 year old female with post-transplant lymphoproliferative disorder, confined to
the central nervous system, which was managed with high dose methotrexate (HDMTX) in the context of end stage renal
disease. The patient received two doses of HDMTX followed by extended hours high-flux hemodialysis, plasma methotrexate
concentration monitoring and leucovorin rescue. The hemodialysis technique used was effective in clearing plasma
methotrexate and allowed delivery of HDMTX to achieve complete remission with limited and reversible direct
methotrexate-related toxicity. Dialysis-dependent renal failure does not preclude the use of HDMTX when required for curative
therapy of malignancy. (AJBR11110001).
Keywords: High dose methotrexate, end stage renal disease, dialysis, primary central nervous system lymphoma,
post-transplant lymphoproliferative disorder
Full Text PDF
Address all correspondence to:
Peter Mollee
Department of Haematology, Pathology Queensland
Princess Alexandra Hospital,
Ipswich Rd, Woolloongabba 4102,
Australia.
Tel: +61 7 32402396
Fax: +61 7 34207042
E-mail: peter_mollee@health.qld.gov.au
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