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.
MeSH terms
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Carrier Proteins / metabolism
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Drug Administration Schedule
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Drug Resistance
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Eye Neoplasms / drug therapy*
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Eye Neoplasms / metabolism
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Eye Neoplasms / pathology
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Female
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Folate Receptors, GPI-Anchored
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Fundus Oculi
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Humans
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Injections
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Lymphoma, Non-Hodgkin / drug therapy*
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Lymphoma, Non-Hodgkin / metabolism
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Lymphoma, Non-Hodgkin / pathology
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Male
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Membrane Transport Proteins / metabolism
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Methotrexate / administration & dosage*
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Methotrexate / therapeutic use
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Microscopy, Confocal
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Middle Aged
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Multidrug Resistance-Associated Proteins / metabolism
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Neoplasm Recurrence, Local / pathology
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Receptors, Cell Surface / metabolism
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Reduced Folate Carrier Protein
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Staining and Labeling
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Vitreous Body
Substances
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Carrier Proteins
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Folate Receptors, GPI-Anchored
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Membrane Transport Proteins
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Multidrug Resistance-Associated Proteins
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Receptors, Cell Surface
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Reduced Folate Carrier Protein
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SLC19A1 protein, human
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Methotrexate