IT or intravenous methotrexate; which is better?

Hello again,

I am receiving IT methotrexate. I read in a study or 2 that showed no protective results from IT methotrexate. The studies claimed it didn't distribute evenly in the cns, nor did it penetrate well the cerebral parenchymal. The studies showed protective results from intravenous methotrexate.

What is your experience with either application of this drug and have you been relapse free?My Dr. didn't offer me methotrexate at first, however I have testes involvement with the DLBCL. 

Thank you again for your input.

Comments

  • Evarista
    Evarista Member Posts: 325 Member
    edited July 2017 #2
    MTX study

    Hi Jim.  Could you provide a link to the study? Might be helpful for addressing your question.  I was told that DLBCL "likes" to home to the CNS as the reason for IT Mtx administration.

  • catwink22
    catwink22 Member Posts: 281
    Hi Jim,

    Hi Jim,

    I had it both ways. I was told the IT was preventive. I just finished my last round of chemo in late May so I dont know about relapse.

    Hope you find further information.

    Cat

  • Jim M
    Jim M Member Posts: 25
    edited July 2017 #4
    Evarista said:

    MTX study

    Hi Jim.  Could you provide a link to the study? Might be helpful for addressing your question.  I was told that DLBCL "likes" to home to the CNS as the reason for IT Mtx administration.

    MTX study

    Here is one link: onlinelibrary.wiley.com>doi>pdf  Or google : Intravenous methotrexate as central nervous system (CNS) prophylaxis is...

  • Sal0101
    Sal0101 Member Posts: 136 Member
    IV

    Jim, 

    I had three IV methotrexate with leucovorin rescue treatments. They were after my 2nd, 4th, and 6th R-Chop treatments.  It was purely prophylactic because I had breast involvement, which they connected with testes involvement.   It was one of those treatments that the oncologist batted around, yes, or no several times. I'm glad I did it or I would have kicked myself in the end. Never once did they recommend intrathecal.

    i did relapse with my DLBCL, but not in the CNS.  I subsequently had a stem cell transplant last September due to the relapse. 

    Sharon

  • po18guy
    po18guy Member Posts: 1,261 Member
    IT as prophylaxis

    I received intrathecal methotrexate as prophylaxis prior to a stem cell transplant. The argument infavor was not compelling, and it was done more or less as a "spray and pray" tactic in case I had central nervous system involvement. In fact, the marrow biopsies did not show any such CNS involvement. If there is an advantage to IV infusion, that would avoid the possibility of infection (Meningitis is always a bad thing) from the IT administration. I would think that alone would be a strong argument in favor of IV administration.  

  • mstar89
    mstar89 Member Posts: 2
    Jim M said:

    MTX study

    Here is one link: onlinelibrary.wiley.com>doi>pdf  Or google : Intravenous methotrexate as central nervous system (CNS) prophylaxis is...

    Hi Jim,

    Hi Jim,

    What did your doctor end up doing? I received intravenous as I am being treated at the hospital that did the study you cited. The sense I've gotten from my oncologist there is that the jury is really still out on what's best, but they have been using intravenous HDMTX for many years and seem to be happy with the results. I don't know much about IT, on the other hand.