Intravitreal methotrexate resistance in a patient with primary intraocular lymphoma

Ocul Immunol Inflamm. 2008 Jan-Feb;16(1):29-33. doi: 10.1080/09273940801899764.

Abstract

Purpose: To describe the clinical course of a patient with multiple recurrences of primary intraocular lymphoma (PIOL).

Design: Interventional case report,

Methods: Retrospective chart review.

Results: A 57-year-old female treated with multiple intravitreal methotrexate injections became refractory to intravitreal methotrexate after a year. Lymphoma cells evaluated using immunocytochemistry and confocal microscopy showed aberrant multidrug resistance-related protein (MRP) and decreased reduced folate carrier (RFC) and folate binding protein (FBP) expression compared to PIOL cells from another patient clinically responsive to methotrexate.

Conclusions: This case suggests that alterations in the transport of methotrexate across the cell membrane might contribute to resistance following repeated intravitreal injections.

Publication types

  • Case Reports

MeSH terms

  • Carrier Proteins / metabolism
  • Drug Administration Schedule
  • Drug Resistance
  • Eye Neoplasms / drug therapy*
  • Eye Neoplasms / metabolism
  • Eye Neoplasms / pathology
  • Female
  • Folate Receptors, GPI-Anchored
  • Fundus Oculi
  • Humans
  • Injections
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / metabolism
  • Lymphoma, Non-Hodgkin / pathology
  • Male
  • Membrane Transport Proteins / metabolism
  • Methotrexate / administration & dosage*
  • Methotrexate / therapeutic use
  • Microscopy, Confocal
  • Middle Aged
  • Multidrug Resistance-Associated Proteins / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Receptors, Cell Surface / metabolism
  • Reduced Folate Carrier Protein
  • Staining and Labeling
  • Vitreous Body

Substances

  • Carrier Proteins
  • Folate Receptors, GPI-Anchored
  • Membrane Transport Proteins
  • Multidrug Resistance-Associated Proteins
  • Receptors, Cell Surface
  • Reduced Folate Carrier Protein
  • SLC19A1 protein, human
  • Methotrexate