Format

Send to

Choose Destination
J Pediatr Hematol Oncol. 2007 Oct;29(10):688-93.

Retrospective study on elimination delay of methotrexate in high-dose therapy of childhood acute lymphoblastic leukemia in China.

Author information

1
Division of Hematology and Oncology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.

Abstract

OBJECTIVES:

The aim of this study was to observe the morbidity of elimination delay in Chinese children with acute lymphoblastic leukemia during high-dose methotrexate (HDMTX) therapy and the toxicities.

PATIENTS AND METHODS:

A total of 121 children with acute lymphoblastic leukemia on HDMTX therapy were enrolled into this study. Patients were divided into groups on the basis of either dosage (3 g/m vs. 5 g/m) or infusion duration (7 h vs. 24 h). CF/MTX index was used to determine the calcium folinate (CF) rescuing intensity and toxicity was evaluated according to World Health Organization criteria.

RESULTS:

The overall morbidity of elimination delay was 12.1% in a total of 497 infusions. Patients with elimination delay had lower platelet count (P<0.01) and greater cumulative CF rescuing intensity (P<0.001). In 3-g group, children with elimination delay experienced severer oral mucous membrane damage (P<0.05) than those without elimination delay, and postponement of following chemotherapy (P=0.001). No significant difference was found in morbidity of elimination delay between 3 and 5-g groups (P>0.05) or 7 and 24-hour infusion groups (P>0.05). The only raised adverse effect in 5-g group was gastrointestinal (P=0.003) as compared with 3-g group. The CF rescuing intensity of 5-g group without elimination delay was lower than that of the 3-g group (P<0.01).

CONCLUSIONS:

(1) HDMTX with 5 g/m is as safe as 3 g/m under adequate hydration and alkalization. Twenty-four-hour infusion is optimal. (2) Individualized dosing is necessary.

PMID:
17921849
DOI:
10.1097/MPH.0b013e31814d6777
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center