scholarly journals Standardized Supportive Care Documentation Improves Safety of High‐Dose Methotrexate Treatment

2020 ◽  
Author(s):  
Winfried H. Alsdorf ◽  
Panagiotis Karagiannis ◽  
Claudia Langebrake ◽  
Carsten Bokemeyer ◽  
Christian Frenzel
Keyword(s):  
Supportive Care ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

High-dose methotrexate treatment and liver function in patients with osteosarcoma

1994 ◽  
Vol 236 (2) ◽  
pp. 209-214 ◽  
Author(s):  
A. FABBRI ◽  
E. MOTTA ◽  
S. FERRARI ◽  
C. LONGHI ◽  
E. MARCHI ◽  
...  
Keyword(s):  
Liver Function ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

Plasma levels of 7-hydroxymethotrexate after high-dose methotrexate treatment

1983 ◽  
Vol 11 (1) ◽  
Author(s):  
G. Milano ◽  
A. Thyss ◽  
N. Renee ◽  
M. Schneider ◽  
M. Namer ◽  
...  
Keyword(s):  
Plasma Levels ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

scholarly journals Chemical pleuritis as the cause of acute chest pain following high-dose methotrexate treatment

Cancer ◽  
1983 ◽  
Vol 51 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Christian Urban ◽  
Anita Nirenberg ◽  
Brenda Caparros ◽  
Sarkis Anac ◽  
Adrienne Cacavio ◽  
...  
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

81 HIGH-DOSE METHOTREXATE TREATMENT IN CHILDREN WITH OSTEOGENIC SARCOMA

1995 ◽  
Vol 17 (4) ◽  
pp. 402
Author(s):  
A Wiela-Hojeńska ◽  
K Orzechowska-Juzwekom ◽  
M Slociak ◽  
J Unolt ◽  
M Hurkacz ◽  
...  
Keyword(s):  
Osteogenic Sarcoma ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

Substitution of l-leucovorin for d,l-leucovorin in the rescue from high-dose methotrexate treatment in patients with osteosarcoma

1993 ◽  
Vol 4 (5) ◽  
pp. 559-564 ◽  
Author(s):  
Norman Jafte ◽  
Keith Jorgensen ◽  
Resa Robertson ◽  
Martine George ◽  
Laurie Letvak ◽  
...  
Keyword(s):  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

Re-challenge with High Dose Methotrexate vs. Reduced Dose After Methotrexate Toxicity in Pediatric Osteosarcoma:Case Report

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Walid Ibrahim ◽  
Alam Alhuda Mohamed ◽  
Nawaf Alkhayat ◽  
Yasser Elborai
Keyword(s):  
Renal Impairment ◽  
Supportive Care ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Reduced Dose ◽  
Dose Methotrexate ◽  
Methotrexate Toxicity ◽  
Renal Complications ◽  
Leucovorin Rescue ◽  
Pediatric Osteosarcoma

Introduction: Methotrexate (MTX), a classic antifolate, is one of the most widely used and well-studied anticancer agents. High-dose methotrexate (HD-MTX) with folinic acid (leucovorin) rescue is one of the standard therapies for osteosarcoma. High-dose methotrexate (HDMTX) can exert significant toxicity and requires complex pharmacokinetic monitoring and leucovorin rescue. The side effect profile of MTX varies markedly according to the dose. Regimens containing MTX are classified as high, intermediate, or low-dose. High-dose methotrexate (HD-MTX; 12 g/m2) is a part of the golden standard therapy for pediatric osteosarcoma (OS). Risk factors associated with MTX toxicity in children with OS are not well defined. Case Presentation: We report here a case of pediatric osteosarcoma with nephrotoxicity associated with delayed MTX excretion who was successfully managed using supportive measures that encouraged us to re-challenge with a full dose of MTX then we reduced the dose to 50% to attain the final critical decision about continuation or changing the regimen of treatment for the patient. Our patient developed moderate renal complications during therapy that improved with supportive care, so we challenged with more cycles of a high dose MTX, but the patient developed serious renal complications. A reduced dose of MTX with 50% was given successfully without any renal impairment. Conclusion: Methotrexate toxicity that might not occur during the initial courses of high-dose MTX is not a predictive of the tolerability of further courses and re-challenging with HDMTX is risky, but reduced dose methotrexate is a good option rather than changing the regimen, with good tolerability and rapid clearance of HDMTX. HDMTX-induced renal impairment occurs in a low percentage of patients with osteosarcoma and can be managed successfully by maximum supportive care. MTX clearance can be affected by gender and age.

Sign in / Sign up

Export Citation Format

Share Document