Transverse Myelitis and Guillain–Barré Syndrome in Pediatric Lymphoid Malignancies: An International Retrospective Study
ABSTRACT Central and peripheral neurotoxicity after methotrexate is a rare but challenging complication of therapy for pediatric lymphoid malignancies. In this Ponte‐di‐Legno Toxicity Working Group and international Berlin‐Frankfurt‐Münster Group study, we describe nine children and adolescents with transverse myelitis ( n = 6) or Guillain–Barré syndrome ( n = 3) after chemotherapy that included methotrexate. All transverse myelitis cases but one occurred in lymphoma patients with central nervous system status 3‐disease, and early imaging and cerebrospinal fluid findings frequently failed to distinguish the two entities. Three patients died from the toxicity, and all survivors of transverse myelitis had permanent deficits. Re‐exposure to intrathecal chemotherapy produced more severe recurrences and should therefore be avoided.
Authors
- Maria Caterina Putti (ORCID: https://orcid.org/0000-0001-7218-8645)
- Sebastian K. Eder (ORCID: https://orcid.org/0000-0001-9061-0504)
- Liv Andrés‐Jensen (ORCID: https://orcid.org/0000-0003-3437-8338)
- Elisa Carraro (ORCID: https://orcid.org/0000-0002-6675-867X)
- Christina Halsey (ORCID: https://orcid.org/0000-0001-5449-5246)
- Kjeld Schmiegelow (ORCID: https://orcid.org/0000-0002-0829-4993)
- Marta Pillon (ORCID: https://orcid.org/0000-0002-1190-3198)
- Lisa Lyngsie Hjalgrim (ORCID: https://orcid.org/0000-0001-5186-3365)
- Andishe Attarbaschi (ORCID: https://orcid.org/0000-0002-9285-6898)
- Maria Winther Gunnes
- Peter E. L. Pontoppidan (ORCID: https://orcid.org/0009-0008-6193-5201)
Institutions
- University of Copenhagen (DK)
- University of Padua (IT)
- Haukeland University Hospital (NO)
- Copenhagen University Hospital (DK)
- Rigshospitalet (DK)
- St Anna Children's Hospital (AT)
- St. Anna Children's Cancer Research Institute
- Medical University of Vienna (AT)
- University of Glasgow (GB)
Publication Details
- Journal
- Pediatric Blood & Cancer
- Published
- 2026-09-16
- DOI
- https://doi.org/10.1002/1545-5017.70695
- Primary Topic
- Acute Lymphoblastic Leukemia research
- Type
- article
- Field-Weighted Citation Impact
- 0.00