scholarly journals Anticancer chemotherapy with high-dose methotrexate

2021 ◽  
Vol 4 (1) ◽  
pp. 30-38
Author(s):  
L.V. Hryvkova
Keyword(s):  
Cytotoxic Effect ◽  
Lymphoblastic Leukemia ◽  
Malignant Neoplasms ◽  
High Dose ◽  
Anticancer Chemotherapy ◽  
Development Of Resistance ◽  
Dose Methotrexate ◽  
The Central Nervous System ◽  
High Doses ◽  
Hodgkin's Lymphomas

The literature review is devoted to the use of high doses of methotrexate in oncology. There is a brief historical overview of the use of methotrexate for the treatment of malignant neoplasms; the main mechanism of its cytotoxic effect on tumor cells, the development of resistance to methotrexate, the main indications for the use of high doses of methotrexate and the main side effects of this treatment are considered. The review details the results of using high doses of methotrexate in the treatment of patients with osteosarcoma, non-Hodgkin’s lymphomas, located mainly in the central nervous system, and acute lymphoblastic leukemia.

scholarly journals Reduced dose folinic acid rescue after rapid high-dose methotrexate clearance is not associated with increased toxicity in a pediatric cohort

2021 ◽  
Author(s):  
Riitta Niinimäki ◽  
Henri Aarnivala ◽  
Joanna Banerjee ◽  
Tytti Pokka ◽  
Kaisa Vepsäläinen ◽  
...  
Keyword(s):  
Folinic Acid ◽  
Lymphoblastic Leukemia ◽  
High Dose ◽  
Optimal Dosage ◽  
High Dose Methotrexate ◽  
Reduced Dose ◽  
Dose Methotrexate ◽  
Antileukemic Effect ◽  
Folinic Acid Rescue ◽  
High Doses

Abstract Purpose Low doses of folinic acid (FA) rescue after high-dose methotrexate (HD-MTX) have been associated with increased toxicity, whereas high doses may be related to a decreased antileukemic effect. The optimal dosage and duration of FA rescue remain controversial. This study was designed to investigate, whether a shorter duration of FA rescue in the setting of rapid HD-MTX clearance is associated with increased toxicity. Methods We reviewed the files of 44 children receiving a total of 350 HD-MTX courses during treatment for acute lymphoblastic leukemia according to the NOPHO ALL-2000 protocol. Following a 5 g/m2 HD-MTX infusion, pharmacokinetically guided FA rescue commenced at hour 42. As per local guidelines, the patients received only one or two 15 mg/m2 doses of FA in the case of rapid MTX clearance (serum MTX ≤ 0.2 μmol/L at hour 42 or hour 48, respectively). Data on MTX clearance, FA dosing, inpatient time, and toxicities were collected. Results Rapid MTX clearance was observed in 181 courses (51.7%). There was no difference in the steady-state MTX concentration, nephrotoxicity, hepatotoxicity, neutropenic fever, or neurotoxicity between courses followed by rapid MTX clearance and those without. One or two doses of FA after rapid MTX clearance resulted in a 7.8-h shorter inpatient time than if a minimum of three doses of FA would have been given. Conclusion A pharmacokinetically guided FA rescue of one or two 15 mg/m2 doses of FA following HD-MTX courses with rapid MTX clearance results in a shorter hospitalization without an increase in toxic effects.

scholarly journals High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia

2018 ◽  
Vol 10 ◽  
pp. 44-51 ◽  
Author(s):  
Wasil Jastaniah ◽  
Naglla Elimam ◽  
Khalid Abdalla ◽  
Aeshah A. AlAzmi ◽  
Mohammed Aseeri ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
T Cell ◽  
Lymphoblastic Leukemia ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Cell Acute Lymphoblastic Leukemia

scholarly journals Infections during high dose methotrexate therapy in childhood acute lymphoblastic leukemia (ALL)

2016 ◽  
Vol 45 (1) ◽  
pp. 6-13
Author(s):  
Taskina Mosleh ◽  
Gulsan Ara Zahan ◽  
Md Kamrul Ahsan Khan ◽  
Afiqul Islam
Keyword(s):  
Prospective Observational Study ◽  
Lymphoblastic Leukemia ◽  
Case Fatality ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Childhood All ◽  
Dose Methotrexate ◽  
Incidence Risk ◽  
To Receive ◽  
Hdmtx Therapy

High-dose methotrexate (HDMTX) therapy is an effective therapy for childhood ALL, which is frequently associated with side effects like infection in our centre. It prolongs hospital stay, delays chemotherapy and causes more economic burden on patients.This study was done to identify the incidence, risk factors and severity of infection among children with ALL during HDMTX therapy.This prospective observational study was conducted among 50 patients suffering from acute lymphoblastic leukemiascheduled to receive HDMTX at the Department of Pediatric Hemato-oncology of BSMMU. It was carried out from January 2012 to June 2012.The end result showed, 19 (38%) patients su_ered from infection; among them microbiologically documented infections found in 9 occasions, where gram negative bacilli - E.coli 4(44.4%) & Pseudomonas 3(33.33%) were predominant organisms. Gastrointestinal tract (GIT) was the most common site (8,42.11%).The rate of infection is significantly higher in children <5 yrs(78.94%). Mortality rate was 6%. As the infection and case fatality rate is quite high with HDMTX therapy, we recommend to use this drug with caution.Bangladesh Med J. 2016 Jan; 45 (1): 6-13

Comparison of pharmacokinetics and toxicity after high-dose methotrexate treatments in children with acute lymphoblastic leukemia

2013 ◽  
Vol 24 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Katalin Csordas ◽  
Marta Hegyi ◽  
Oliver T. Eipel ◽  
Judit Muller ◽  
Daniel J. Erdelyi ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate
Sign in / Sign up

Export Citation Format

Share Document