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Journal of Pediatric Psychology Advance Access originally published online on May 4, 2006
Journal of Pediatric Psychology 2007 32(2):189-193; doi:10.1093/jpepsy/jsj114
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Brief Report: Effect of Intravenous Methotrexate Dose and Infusion Rate on Neuropsychological Function One Year after Diagnosis of Acute Lymphoblastic Leukemia

Marissa E. Carey, PhD1, Marilyn J. Hockenberry, PhD2,3, Ida M. Moore, DNS4, John J. Hutter, MD5, Kevin R. Krull, PhD2,6, Alice Pasvogel, PhD4 and Kris L. Kaemingk, PhD5

1 Department of Behavioral Medicine and Psychiatry, West Virginia University, 2 Department of Pediatrics, Baylor College of Medicine, 3 Texas Children’s Cancer Center, 4 College of Nursing, 5 Department of Pediatrics, The University of Arizona, and, 6 Texas Children’s Hospital

All correspondence concerning this article should be addressed to Marissa E. Carey, West Virginia University, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, P.O. Box 9137, Morgantown, West Virginia 26505. E-mail: mcarey{at}hsc.wvu.edu.


  Abstract

Objective To compare the effects of two intravenous (IV) methotrexate (MTX) infusion protocols on cognitive function in children newly diagnosed with acute lymphoblastic leukemia (ALL). Methods We compared 19 children treated with 1 g/m2 of IV MTX over 24 hr (Group 1) to 13 children treated with 2 g/m2 of IV MTX over 4 hr (Group 2) on measures of working memory, nonverbal, and verbal skills shortly after diagnosis (Time 1) and 1 year later (Time 2). Results A significant GroupxTime interaction was found for a composite measure of working memory with Group 2 declining from Time 1 to Time 2. Group 2 performed significantly worse than Group 1 on a composite measure of nonverbal skills at both time points. Conclusions Findings suggest that difficulties in working memory and nonverbal skills may be evident during the first year of treatment for ALL and that severity may be dependent on IV MTX dose and/or infusion rate.

Key words: acute lymphoblastic leukemia; chemotherapy; methotrexate; neuropsychology.

Received August 3, 2005; revision received November 16, 2005; revision received February 2, 2006; accepted March 20, 2006


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