Methotrexate Leukemia - Crossref

Is hypoalbuminemia a risk factor for high-dose methotrexate toxicity in children with acute lymphoblastic leukemia?

Abstract Background: The repeated high-dose methotrexate is a common component of modern pediatric acute lymphoblastic leukemia therapy regimens. Plasma MTX levels were estimated at 24 h from the start of HDMTX infusion in the first consolidation cycle at 24 h from the start of the first consolidation cycle. Before HDMTX administration, a measurable serum albumin level was determined, but pre-infusion hypoalbuminemia was defined as serum albumin was > 3. 5 g/dL. Pre-infusion anemia, Grade 3–4 thrombocytopenia, febrile neutropenia, and oral mucositis were significantly more prevalent in HDMTX cycles with pre-infusion hypoalbuminemia than those with normal pre-infusion albumin. Oral mucositis was more prevalent in the 2. 5 g/m2 than the 5 g/m 2 HDMTX cycles. Conclusions Serum albumin levels should be investigated before starting HDMTX cycles, particularly in resource-limited settings where malnutrition is common, and serum MTX testing may not be available. Optimizing serum albumin levels before HDMTX can reduce the likelihood of HDMTX-related toxicities.

Source link: https://doi.org/10.1186/s43046-022-00122-7

The effect of the plasma methotrexate concentration during high-dose methotrexate therapy on prognosis of childhood acute lymphoblastic leukemia

This research was to investigate the prevalence factors and prognostic importance of the plasma MTX concentration in ALL. For the non-LR group, the median 24h MTX concentrations were 42. 0 mol/L for LR and 70. 0 mol/L for the non LR group. The 24h MTX concentrations were found in the LR group and age in the non LR group. In 211/1435 courses of 125 patients, which more commonly resulted in MTX-induced toxicities, there was a delay. In patients with MTX excretion delay, all the 6 CNS relapses occurred, but those without have no CNS relapse occurred. Patients on more than half of MTX excretion delay courses had a dramatic decrease in longevity. Conclusions: Achieving the target 24h MTX concentration during HD-MTX therapy is not the only way to determine ALL patients's survival.

Source link: https://doi.org/10.22541/au.164866504.46536405/v1

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