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Methotrexate Leukemia - Europe PMC

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Last Updated: 02 May 2022

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Hypoalbuminemia and not undernutrition predicts high-dose methotrexate-induced nephrotoxicity in children with acute lymphoblastic leukemia in resource-constrained centers.

Background The objective of this study is to monitor serum MTX levels until they fall below a predetermined threshold. Though hypoalbuminemia has been promoted as a risk factor for HMN, the relationship between undernutrition and HMN has not been investigated. Methods This multi-year retrospective observational research enrolled children up to 12 years old, with all receiving HD-MTX. Two weeks before HD-MTX infusion, children with preexisting renal disease and exposed to nephrotoxic drugs were barred. Various factors affecting HMN were found: age, sex, model of ALL, risk group of ALL, first dose of MTX, dose of MTX, undernourishment, serum protein, and albumin, as well as C-reactive protein and MTX36 levels were reported. Forty-four children were analyzed after 150 HD-MTX cycles. Hypoalbuminemia and single serum MTX levels predict HMN in centers where serial MTX level monitoring is not feasible.

Source link: https://europepmc.org/article/MED/35451162


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

Background repeating high-dose methotrexate is a key component of current pediatric acute lymphoblastic leukemia therapy regimens. Hypoalbuminemia in children with leukemia is not unusual. This research was designed to investigate the relationship between pre-infusion serum albumin and potential HDMTX toxicities. In the first consolidation cycle, Plasma MTX levels were estimated at 24 h from the start of HDMTX infusion in the first consolidation cycle. Before HDMTX administration, serum albumin level was determined, but pre-infusion hypoalbuminemia was established when serum albumin was 3. 5 g/dL. Regardless of the MTX dose, most HDMTX toxicities were similar. Oral mucositis was more common in the 2. 5 g/m2 than the 5 g/m 2 HDMTX cycles. Conclusions: Serum albumin levels should be tested before starting HDMTX cycles, particularly in resource-limited settings where hunger is common, and serum MTX testing may not be available. Optimizing serum albumin levels before HDMTX may help minimize the risk of HDMTX-toxicities.

Source link: https://europepmc.org/article/MED/35434757


An observational MRI study of methotrexate-treated children with acute lymphoblastic leukemia in remission and subtle cognitive decline.

Background For children with acute lymphoblastic leukemia, methotrexate therapy reduces the likelihood of leukoencephalopathy and other treatment-related brain damage. To clarify the specific effects of MTX treatment in this group, a more comprehensive research is required. After MTX therapy, this study was designed to investigate changes in brain metabolites, diffusion, and anisotropy characteristics, as well as cognitive results in children with all MTX treatment. Methods In this observational research, 30 children with ALL and 30 healthy children were recruited and assessed from December 2013 to December 2015 using baseline magnetic resonance imaging, magnetic resonance spectroscopy, diffusion tensor imaging, and neurocognitive testing. The children with all underwent MR examination and neurocognitive testing again after MTX therapy and ALL remission. Quantitative enhancements of MR and cognitive test results from baseline data were estimated. The ADC values in the corpus callosum, the internal capsule's genu, did not change from baseline, while the occipital lobe did not change from baseline. All children above the age of 6 years were positively correlated with the decrease in the N-acetylaspartate/creatine ratio at the genu of the corpus callosum of children. Conclusions: MTX therapy effects subtle cognitive decline in children with ALL in remission and may have a large effect on their brain metabolites, but changes in white matter diffusion methods are limited to the frontal lobe and corpus callosum.

Source link: https://europepmc.org/article/MED/35371933


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

The median 24h MTX concentrations were 42. 0 mol/L for LR and 70. 0 mol/L for the non-LR group. Only SLCO1B1 genotype in the LR group and age in the non LR group were associated with the 24-h MTX concentrations. The survival results were similar between patients with or without courses, with or without courses failing to achieve the target 24h MTX concentration. In 213/135 courses of 125 patients, which more often resulted in MTX-induced toxicities, there was a delay. In patients with MTX excretion delay, relapses occurred in those without, but not in those without did not experience any form of CNS relapse. Patients on more than half of the MTX excretion delay courses had a dramatic decline in adherence. Conclusions: Achieving the target 24h MTX concentration during HD-MTX therapy is not a valid way to determine ALL patients's survival.

Source link: https://europepmc.org/article/PPR/PPR475248


Hypersensitivity reaction to high-dose methotrexate and methotrexate-induced acral erythema in a child with acute lymphoblastic leukemia.

Following acute lymphoblastic leukemia treatment, a 9-year-old boy with acute lymphoblastic leukemia developed a hypersensitivity reaction and erythema. Both HSR and acral erythema are uncommon adverse events of MTX therapy, and MTX has not been shown to cause HSRs in particular ethnic groups. During the first and second HDMTX courses, HSR appeared on the first and second HDMTX courses. Acral erythema was treated with compassionate care, without dose reduction or interval lengthening. Even before the first course, HSRs to MTX should be considered.

Source link: https://europepmc.org/article/MED/35343432


Methotrexate-related central neurotoxicity: clinical characteristics, risk factors and genome-wide association study in children treated for acute lymphoblastic leukemia.

A common toxicity seen during acute lymphoblastic leukemia therapy with potential long-term neurologic problems is symptomatic methotrexate-related central neurotoxicity. Using regression, clinical risk predictors for MTX neurotoxicity were analyzed. The incidence of MTX neurotoxicity was 7. 6% at a median of 4 months from ALL diagnosis and 8 days after intravenous or intrathecal MTX. Following symptomatic MTX neurotoxicity, Cumulative relapse in children where intrathecal MTX was omitted was elevated in children where intrathecal MTX was omitted, compared to intrathecal MTX where intrathecal MTX was maintained throughout therapy. When intrathecal MTX was cut off, it was 89. 2 percent, compared to 95. 6 percent when intrathecal MTX was maintained. After the first episode, the incidence of MTX neurotoxicity was low among patients with intrathecal MTX. After a first MTX neurotoxicity event, our results show that no evidence points to the cessation of intrathecal MTX.

Source link: https://europepmc.org/article/MED/33567813


Prodrug based on halloysite delivery systems to improve the antitumor ability of methotrexate in leukemia cell lines.

Both methotrexate drug molecules and biotin ligand moieties, whose receptors are overexpressed on the surface of several cancer cells' surface, were loaded on halloysite nanotubes to produce nanomaterial based on multifunctional and "smart" delivery systems in this context. i a supramolecular reaction of the clay and the drug; ii a covalent graft of the drug onto the HNTs external surface; and, ii a combination of both methods. Eventually, as a proof-of-concept application of our HNT-based cancer treatment's chemotherapy, acute myeloid leukemia cell lines, HL60, and its multidrug resistance variant, HL60R, were tested on acute myeloid leukemia cell lines, HL60 and its multidrug resistance version, HL60R. Both the MTX prodrug system and the biotinylated ones played a vital role in the biological development and, in fact, they are promising cancer treatment agents.

Source link: https://europepmc.org/article/MED/35168104


Upper gastrointestinal bleeding secondary to toxicity by anthracyclines, citarabine and methotrexate in patient with acute lymphoblastic leukemia.

In the hematology ward for chemotherapy treatment, a 60-year-old male patient with no medical history but acute lymphoblastic leukemia was accepted. In the second half of the duodenum, erosophagitis, gastritis, and duodenitis, As well as Forrest III ulcers in the duodenal bulb and multiple Forrest IIb ulcers were discovered.

Source link: https://europepmc.org/article/MED/35100805

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

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* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions