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Neutropenia was most severe following courses that included either systemic or intrathecal methotrexate, even in the face of major dose reductions. Delays in the development of neutropenia\u2010during periods of leucovorin administration also implicate methotrexate as the primary responsible agent. This case suggests that certain immunodeficiency states predispose patients to extensive chemotherapy\u2010induced myelosuppression and supports the concept that purine salvage is a clinically important mechanism for modulating methotrexate toxicity.<\/jats:p>","DOI":"10.1002\/mpo.2950180415","type":"journal-article","created":{"date-parts":[[2007,2,20]],"date-time":"2007-02-20T18:07:16Z","timestamp":1171994836000},"page":"329-332","source":"Crossref","is-referenced-by-count":1,"title":["Excessive chemotherapy\u2010related granulocytopenia in a child with non\u2010Hodgkin's lymphoma and a congenital abnormality of purine salvage"],"prefix":"10.1002","volume":"18","author":[{"given":"Julie","family":"Blatt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,7,20]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-198722000-00017"},{"key":"e_1_2_1_3_2","volume-title":"Principles and Practice of Pediatric Oncology","author":"Weinberg KI","year":"1989"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-1229(86)90081-4"},{"key":"e_1_2_1_5_2","first-page":"101","article-title":"Purine nucleoside phosphorylase deficiency with molluscum contagiousm and non\u2010Hodgkin's lymphoma","volume":"11","author":"Sukanich A","year":"1989","journal-title":"Immunol Allergy Pract"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950080104"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950040305"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI112872"},{"key":"e_1_2_1_9_2","first-page":"641","article-title":"Utilizacion de las vias de rescati de purinas por celulars L1210 expulstas a methotrexate in vitro","volume":"29","author":"Bulsa JM","year":"1982","journal-title":"Rev Esp Oncol"},{"key":"e_1_2_1_10_2","first-page":"945","article-title":"Thymidine and hypoxanthine requirements of normal and malignant human cells for protection against methotrexate cytotoxicity","volume":"41","author":"Howell SB","year":"1981","journal-title":"Cancer Res"},{"key":"e_1_2_1_11_2","first-page":"1866","article-title":"Methotrexate and dipyridimole combination chemotherapy based on inhibition of nucleoside salvage in humans","volume":"49","author":"Willson JKV","year":"1989","journal-title":"Cancer Res"},{"key":"e_1_2_1_12_2","first-page":"3466","article-title":"Biochemical strategy of cancer cells and the design of chemotherapy: G.H.A. Clowes Memorial Lecture","volume":"43","author":"Weber G","year":"1983","journal-title":"Cancer Res"},{"key":"e_1_2_1_13_2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1182\/blood.V56.3.380.380","article-title":"Purine nucleoside phosphorylase activity in acute lymphoblastic leukemia","volume":"56","author":"Blatt J","year":"1980","journal-title":"Blood"}],"container-title":["Medical and Pediatric Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmpo.2950180415","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mpo.2950180415","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T18:32:53Z","timestamp":1697999573000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mpo.2950180415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,1]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1990,1]]}},"alternative-id":["10.1002\/mpo.2950180415"],"URL":"https:\/\/doi.org\/10.1002\/mpo.2950180415","archive":["Portico"],"relation":{},"ISSN":["0098-1532","1096-911X"],"issn-type":[{"value":"0098-1532","type":"print"},{"value":"1096-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1990,1]]}}}