Methotrexate-induced alterations in beta-oxidation correlate with cognitive abilities in children with acute lymphoblastic leukemia

Ida M Moore, Petra Miketova, Marilyn Hockenberry, Kevin Krull, Alice E Pasvogel, Marissa Carey, Kris Kaemingk

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Treatment advances, including central nervous system (CNS) treatment with methotrexate, have led to significant gains in disease-free survival from childhood acute lymphoblastic leukemia (ALL). However, methotrexate has been associated with neurological problems such as declines in cognitive and academic abilities. The purpose of this study was to investigate methotrexate-induced changes in beta-oxidation in children with ALL receiving methotrexate for CNS treatment. Specific aims were to investigate effects of methotrexate on beta-oxidation of the two most prevalent fatty acids (palmitic acid and stearic acid) in cerebrospinal fluid (CSF) samples and correlate the ratio of monounsaturation to saturation of these fatty acids with cognitive and academic abilities. The sample included 12 females and 14 males with low-risk (n = 7), standard-risk ( n = 13), or high-risk (n = 6) ALL. Mean age at diagnosis was 94.1 months (SD = 34.4). CSF samples were obtained in conjunction with diagnostic lumbar punctures; subsequent samples were obtained prior to intrathecal methotrexate administration during the induction, consolidation, and continuation phases of treatment. Fatty acids were analyzed by gas chromatography. Results showed a significant increase in the ratio of monounsaturation to saturation of both fatty acids, which was greatest during the most intensive phase of treatment. Ratios of monounsaturated to saturated fatty acids were negatively correlated with full-scale IQ, verbal IQ, and math calculations. Findings suggest that methotrexate alters beta-oxidation and that the resulting increase in fatty acid monounsaturation is related to declines in some domains of cognitive ability.

Original languageEnglish (US)
Pages (from-to)311-319
Number of pages9
JournalBiological Research for Nursing
Volume9
Issue number4
DOIs
StatePublished - Apr 2008

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Aptitude
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Methotrexate
Fatty Acids
Cerebrospinal Fluid
Central Nervous System
Therapeutics
Spinal Puncture
Palmitic Acid
Gas Chromatography
Disease-Free Survival

Keywords

  • Beta-oxidation
  • Childhood leukemia
  • Cognitive and academic abilities
  • Methotrexate

ASJC Scopus subject areas

  • Research and Theory

Cite this

Methotrexate-induced alterations in beta-oxidation correlate with cognitive abilities in children with acute lymphoblastic leukemia. / Moore, Ida M; Miketova, Petra; Hockenberry, Marilyn; Krull, Kevin; Pasvogel, Alice E; Carey, Marissa; Kaemingk, Kris.

In: Biological Research for Nursing, Vol. 9, No. 4, 04.2008, p. 311-319.

Research output: Contribution to journalArticle

Moore, Ida M ; Miketova, Petra ; Hockenberry, Marilyn ; Krull, Kevin ; Pasvogel, Alice E ; Carey, Marissa ; Kaemingk, Kris. / Methotrexate-induced alterations in beta-oxidation correlate with cognitive abilities in children with acute lymphoblastic leukemia. In: Biological Research for Nursing. 2008 ; Vol. 9, No. 4. pp. 311-319.
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