methotrexate IV

He was started on levetiracetam for a first-time seizure and discharged...Two weeks later, high-dose methotrexate plus cytarabine was initiated, with neurological improvement...Computed tomography (CT) showed no new intracranial findings, but pancytopenia and cultures positive for carbapenem-resistant Citrobacter freundii were identified, and he died of septic shock. This case illustrates that CNS ALCL can radiographically mimic metastatic disease, underscores the necessity of tissue diagnosis, and highlights the competing imperatives of timely intensive chemotherapy and rigorous infection surveillance, particularly for multidrug-resistant organisms in older adults with PCNSL.

P=N/A, N=20, Completed, Ohio State University Comprehensive Cancer Center | Active, not recruiting --> Completed | Trial completion date: Nov 2026 --> Dec 2025

P1, N=14, Completed, Wake Forest University Health Sciences | Active, not recruiting --> Completed

Due to transaminitis, high-dose methotrexate therapy was deferred, and the patient was initiated on intrathecal (IT) chemotherapy with methotrexate and cytarabine. Following five cycles of IT chemotherapy, the patient's neurologic status significantly improved, and CSF analysis showed resolution of the atypical T-cell population. This case highlights the rare occurrence of CNS progression of FMF, even in the absence of lymphatic involvement and with well-controlled skin manifestations, and underscores the role of IT chemotherapy in managing this complication.

P2, N=42, Not yet recruiting, Minia University

P2, N=16, Recruiting, Wake Forest University Health Sciences | Trial primary completion date: Dec 2025 --> May 2026

Treatment with rituximab, high-dose methotrexate, and focal radiotherapy was initiated...Liquid biopsy of the CSF provides a promising alternative for diagnosing PISCL. However, further studies are needed to validate the clinical utility of this diagnostic approach.

While topical corticosteroids are the most common treatment adopted, other options include watchful waiting, phototherapy and systemic methotrexate...Clinicians should remain vigilant in diagnosing LyP. Although its course is often benign, the association with haematological malignancy requires both careful clinicopathological correlation for diagnosis and long-term follow-up.

P4, N=0, Withdrawn, Takeda | Trial completion date: Jul 2028 --> Aug 2025 | Recruiting --> Withdrawn | Trial primary completion date: Jul 2028 --> Aug 2025

The ABLE risk-stratification model can effectively differentiate prognostic subgroups in patients with PCNSL.

This pathway-informed approach identifies genetic contributors to methotrexate-induced mucositis and supports polygenic risk prediction. Our findings provide a foundation for individualized toxicity risk profiling and suggest potential therapeutic targets to mitigate treatment-limiting mucositis in pediatric oncology.

It was revealed that the lymphoma cells of both lymphoplasmacytic lymphoma/Waldenström macroglobulinemia and primary central nervous system lymphoma derived from a common cell possessing MYD88. The utility of adding chemotherapy for low-grade lymphoma in addition to therapy for primary central nervous system lymphoma is not clear. While lymphoplasmacytic lymphoma is a low-grade lymphoma that does not always require chemotherapy, combining treatment for lymphoplasmacytic lymphoma and primary central nervous system lymphoma may contribute to the effectiveness of both treatments.