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Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series.

Publication ,  Journal Article
Taylor, OA; Hockenberry, MJ; McCarthy, K; Gundy, P; Montgomery, D; Ross, A; Scheurer, ME; Moore, IM
Published in: Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
September 2015

Central nervous system (CNS) treatment is an essential part of acute lymphocytic leukemia (ALL) therapy, and the most common CNS treatment is intrathecal (IT) and high-dose intravenous (IV) methotrexate (MTX). Treatment with MTX may cause neurotoxicity, which is often accompanied by neurologic changes, delays in treatment, and prolonged hospital stays. This article reports clinical presentations of 3 patients with severe MTX toxicity as well as levels of oxidative stress and apoptosis biomarkers in cerebrospinal fluid (CSF). Oxidative stress was measured by oxidized phosphatidylcholine (PC), oxidized phosphatidylinositol (PI), and F2 isoprostanes; apoptosis was measured by caspase 3/7 activity. Most consistent biomarker changes in all 3 cases were increases in caspase 3/7 and F2 isoprostanes prior to acute toxicity while increases in oxidized phospholipids occurred slightly later. Progressive increases in F2 isoprostanes and caspase 3/7 activity prior to and/or during acute toxicity suggests MTX induces oxidative stress and an associated increase in apoptosis. These findings support the role of oxidative stress in MTX-related neurotoxicity.

Duke Scholars

Published In

Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses

DOI

EISSN

1532-8457

ISSN

1043-4542

Publication Date

September 2015

Volume

32

Issue

5

Start / End Page

320 / 325

Related Subject Headings

  • Severity of Illness Index
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oxidative Stress
  • Nursing
  • Methotrexate
  • Male
  • Infusions, Intravenous
  • Humans
  • Female
  • Diagnosis, Differential
 

Citation

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Taylor, O. A., Hockenberry, M. J., McCarthy, K., Gundy, P., Montgomery, D., Ross, A., … Moore, I. M. (2015). Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series. Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses, 32(5), 320–325. https://doi.org/10.1177/1043454214563409
Taylor, Olga A., Marilyn J. Hockenberry, Kathy McCarthy, Patricia Gundy, David Montgomery, Adam Ross, Michael E. Scheurer, and Ida M. Moore. “Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series.Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses 32, no. 5 (September 2015): 320–25. https://doi.org/10.1177/1043454214563409.
Taylor OA, Hockenberry MJ, McCarthy K, Gundy P, Montgomery D, Ross A, et al. Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series. Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses. 2015 Sep;32(5):320–5.
Taylor, Olga A., et al. “Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series.Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses, vol. 32, no. 5, Sept. 2015, pp. 320–25. Epmc, doi:10.1177/1043454214563409.
Taylor OA, Hockenberry MJ, McCarthy K, Gundy P, Montgomery D, Ross A, Scheurer ME, Moore IM. Evaluation of Biomarkers of Oxidative Stress and Apoptosis in Patients With Severe Methotrexate Neurotoxicity: A Case Series. Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses. 2015 Sep;32(5):320–325.
Journal cover image

Published In

Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses

DOI

EISSN

1532-8457

ISSN

1043-4542

Publication Date

September 2015

Volume

32

Issue

5

Start / End Page

320 / 325

Related Subject Headings

  • Severity of Illness Index
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oxidative Stress
  • Nursing
  • Methotrexate
  • Male
  • Infusions, Intravenous
  • Humans
  • Female
  • Diagnosis, Differential