[Managing methotrexate toxicity: a case report].

M J Fernández Megía; M Alós Almiñana; M J Terol Castera

PubMed · 15504095

[Managing methotrexate toxicity: a case report].

M J Fernández Megía·M Alós Almiñana·M J Terol Castera

Abstract

High-dose methotrexate is included in chemotherapy regimens used to treat a number of malignant neoplasms. Methotrexate plasma concentration is considered the best toxicity predictor. Monitoring methotrexate plasma concentrations is standard practice in the identification of at-risk patients, the titration of folinic acid doses, and the establishment of corrective measures. Methotrexate is a kidney-cleared weak acid, and renal function impairment may retard methotrexate clearance. A case of severe methotrexate-induced toxicity secondary to renal failure is reported in a patient with non-Hodgkin s lymphoma receiving methotrexate at a dose of 1 g/m2. Corrective measures included folinic acid rescue therapy, cholestyramine resin administration, hydration and urine alkalinization, urine pH monitoring, and extracorporeal clearance techniques.

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Acute Kidney Injury Aged Anion Exchange Resins Antimetabolites, Antineoplastic Cholestyramine Resin Humans Hydrogen-Ion Concentration Leucovorin Lymphoma, Non-Hodgkin Male Methotrexate Treatment Outcome Case Reports English Abstract Journal Article

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M J Fernández Megía, M Alós Almiñana, M J Terol Castera. [Managing methotrexate toxicity: a case report].. https://pubmed.ncbi.nlm.nih.gov/15504095/

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