Serum creatinine and creatinine clearance for predicting plasma methotrexate concentrations after high-dose methotrexate chemotherapy for the treatment for childhood lymphoblastic malignancies

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• 作者：Wei-qun Xu (1)
  Ling-yan Zhang (1)
  Xue-ying Chen (1)
  Bin-hua Pan (1)
  Jun-qing Mao (1)
  Hua Song (1)
  Jing-yuang Li (1)
  Yong-min Tang (1)
  
• 关键词：High ; dose methotrexate ; Elimination delay ; Acute lymphoblastic leukemia ; Childhood ; Non ; Hodgkin lymphoma ; Creatinine clearance
• 刊名：Cancer Chemotherapy and Pharmacology
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：73
• 期：1
• 页码：79-86
• 全文大小：365 KB
• 作者单位：Wei-qun Xu (1)
  Ling-yan Zhang (1)
  Xue-ying Chen (1)
  Bin-hua Pan (1)
  Jun-qing Mao (1)
  Hua Song (1)
  Jing-yuang Li (1)
  Yong-min Tang (1)
  
  1. Division of Hematology-Oncology, Children’s Hospital of Zhejiang University, School of Medicine, #57 Zhuganxiang Road, Yan-an Street, Hangzhou, 310003, People’s Republic of China
  
• ISSN：1432-0843

文摘

Purpose Monitoring of plasma methotrexate (MTX) concentrations allows for therapeutic adjustments in treating childhood acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL) with high-dose MTX (HDMTX). We tested the hypothesis that assessment of creatinine clearance (CrCl) and/or serum Cr may be a suitable means of monitoring plasma MTX concentrations. Methods All children in the study had ALL or NHL, were in complete remission, and received HDMTX (3 or 5?g/m2)+leucovorin. Plasma MTX concentrations were measured at 24, 48, and 96?h. CrCl was determined at 24 and 48?h. Correlations between 24- and 48-h plasma MTX concentrations and CrCl and serum Cr concentrations were determined. CrCl and serum Cr concentrations were compared over time between children who had delayed and non-delayed MTX elimination. Results A total of 105 children were included. There were significant negative correlations between CrCl at 24 and 48?h and plasma MTX concentrations at 24 (both p?<?0.001) and 48?h (both p?<?0.001). There were significant positive correlations between serum Cr concentrations at both 24 and 48?h and plasma MTX concentrations at 24 (both p?<?0.001) and 48?h (both p?<?0.001). There were 88 (30.2?%) instances of elimination delay. Children with elimination delay had significantly lower CrCl and higher Cr concentrations at 24 and 48?h compared with children without elimination delay (all p?<?0.05). Conclusion Our findings suggest that, with further refinement, assessment of renal function may be a useful means of monitoring plasma MTX concentrations during HDMTX for ALL and NHL.