Aminophylline Administration for Treatment of Methotrexate-Induced Neurotoxicity in Pediatric Cancer Patients: A Single-Center Case Series.

Intrathecal methotrexate (MTX) remains a critical component in multiagent chemotherapy regimens for acute lymphoblastic leukemia (ALL). However, MTX-induced neurotoxicity (MIN) can cause significant morbidity. Aminophylline can be a treatment for MIN, mitigating neurotoxicity, but its use has been restricted to case reports and small patient series. In this report, we present treatment outcomes of seven patients who developed MIN and received aminophylline. The median time-to-improvement after aminophylline was 9 h, and the median time to full resolution of symptoms was 36 h. All patients developed full symptom resolution, advocating aminophylline as treatment of MIN in patients with ALL.