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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background: High doses of methotrexate (MTX) are often used in various chemotherapy protocols to treat acute lymphoblastic leukemia (ALL) and non-Hodgkin’s lymphoma (NHL) in children, but its delayed elimination increases the occurrence of adverse events, such as bone marrow suppression. The aim of this study was to investigate the elimination of MTX at 24 and 48 hours. Methods: We retrospectively analyzed electronic medical records of ALL or NHL pediatric patients who received 5 g/m2 MTX infusion over 24 hours (between June, 2012 and July, 2018) at the Yonsei University Health System, Korea. The delayed elimination of MTX concentrations was assessed with 100 or 150 μM MTX at 24 hours, and 2 or 5 μM at 48 hours. Results: Among the 85 MTX cycles administered, 23 cycles were classified in delayed elimination group, and 62 cycles showed normal elimination. At 24 hours, the delayed elimination group with MTX concentration > 100 μM showed higher percentage than group with MTX concentration < 100 μM (45.8% vs. 19.7%, p = 0.015). However, no differences were observed at 150 μM MTX (p = 0.66). At 48 hours, the delayed elimination was higher than the normal elimination at both concentration baselines (p < 0.001 at 2 μM, p = 0.024 at 5 μM). Conclusions: MTX concentrations greater than 100 μM show high probability of delayed elimination at 24 hours. When MTX levels are above normal, leucovorin and hydration regimens should be continued to prevent delayed elimination.
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참고문헌 (25)
참고문헌 신청
Csordas K / 2013 / Comparison of pharmacokinetics and toxicity after high-dose methotrexate treatments in children with acute lymphoblastic leukemia / Anticancer Drugs 24(2):189~197
Cerminara Z / 2017 / A single center retrospective analysis of a protocol for high-dose methotrexate and leucovorin rescue administration / J Oncol Pharm Pract
Mao J / 2014 / Creatinine clearance rate and serum creatinine concentration are related to delayed methotrexate elimination in children with lymphoblastic malignancies / Neoplasma 61(1):77~82
Xu W / 2007 / Retrospective study on elimination delay of methotrexate in high-dose therapy of childhood acute lymphoblastic leukemia in China / J Pediatr Hematol Oncol 29(10):688~693
Howard SC / 2016 / Preventing and Managing Toxicities of High-Dose Methotrexate / Oncologist 21(12):1471~1482
Cerminara Z / 2017 / A single center retrospective analysis of a protocol for high-dose methotrexate and leucovorin rescue administration / J Oncol Pharm Pract
Mao J / 2014 / Creatinine clearance rate and serum creatinine concentration are related to delayed methotrexate elimination in children with lymphoblastic malignancies / Neoplasma 61(1):77~82
Xu W / 2007 / Retrospective study on elimination delay of methotrexate in high-dose therapy of childhood acute lymphoblastic leukemia in China / J Pediatr Hematol Oncol 29(10):688~693
Howard SC / 2016 / Preventing and Managing Toxicities of High-Dose Methotrexate / Oncologist 21(12):1471~1482
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