Effective removal of methotrexate by high-flux hemodialysis

Jeffrey M. Saland; Patrick J. Leavey; Robert O. Bash; Eleonora Hansch; Gerald S. Arbus; Raymond Quigley

doi:10.1007/s00467-002-0946-7

Effective removal of methotrexate by high-flux hemodialysis

Jeffrey M. Saland, Patrick J. Leavey, Robert O. Bash, Eleonora Hansch, Gerald S. Arbus, Raymond Quigley

Research output: Contribution to journal › Article › peer-review

68 Scopus citations

Abstract

The purpose of the present study was to examine the clearance of methotrexate (MTX) by high-flux hemodialysis (HD) in pediatric oncology patients. We present three patients who experienced nephrotoxicity and prolonged exposure to toxic MTX concentrations following high-dose infusions during treatment for osteogenic sarcomas. Each patient was successfully treated with high-flux HD, followed by carboxypeptidase G₂ (CPDG₂) in two cases. Minimal systemic toxicity occurred. We review the literature and discuss guidelines for early and aggressive treatment for this complication of high-dose MTX therapy. Clinically important removal of MTX depends upon prompt initiation of HD after detection of nephrotoxicity and delayed clearance of MTX. Therapy is indicated in cases where compassionate use of CPDG₂ may not be available, or while awaiting its delivery.

Original language	English (US)
Pages (from-to)	825-829
Number of pages	5
Journal	Pediatric Nephrology
Volume	17
Issue number	10
DOIs	https://doi.org/10.1007/s00467-002-0946-7
State	Published - 2002

Keywords

Antineoplastic-antimetabolites
Bone neoplasms
Hemodialysis
Toxicology

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Nephrology

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10.1007/s00467-002-0946-7

Cite this

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title = "Effective removal of methotrexate by high-flux hemodialysis",

abstract = "The purpose of the present study was to examine the clearance of methotrexate (MTX) by high-flux hemodialysis (HD) in pediatric oncology patients. We present three patients who experienced nephrotoxicity and prolonged exposure to toxic MTX concentrations following high-dose infusions during treatment for osteogenic sarcomas. Each patient was successfully treated with high-flux HD, followed by carboxypeptidase G2 (CPDG2) in two cases. Minimal systemic toxicity occurred. We review the literature and discuss guidelines for early and aggressive treatment for this complication of high-dose MTX therapy. Clinically important removal of MTX depends upon prompt initiation of HD after detection of nephrotoxicity and delayed clearance of MTX. Therapy is indicated in cases where compassionate use of CPDG2 may not be available, or while awaiting its delivery.",

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author = "Saland, {Jeffrey M.} and Leavey, {Patrick J.} and Bash, {Robert O.} and Eleonora Hansch and Arbus, {Gerald S.} and Raymond Quigley",

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T1 - Effective removal of methotrexate by high-flux hemodialysis

AU - Saland, Jeffrey M.

AU - Leavey, Patrick J.

AU - Bash, Robert O.

AU - Hansch, Eleonora

AU - Arbus, Gerald S.

AU - Quigley, Raymond

PY - 2002

Y1 - 2002

N2 - The purpose of the present study was to examine the clearance of methotrexate (MTX) by high-flux hemodialysis (HD) in pediatric oncology patients. We present three patients who experienced nephrotoxicity and prolonged exposure to toxic MTX concentrations following high-dose infusions during treatment for osteogenic sarcomas. Each patient was successfully treated with high-flux HD, followed by carboxypeptidase G2 (CPDG2) in two cases. Minimal systemic toxicity occurred. We review the literature and discuss guidelines for early and aggressive treatment for this complication of high-dose MTX therapy. Clinically important removal of MTX depends upon prompt initiation of HD after detection of nephrotoxicity and delayed clearance of MTX. Therapy is indicated in cases where compassionate use of CPDG2 may not be available, or while awaiting its delivery.

AB - The purpose of the present study was to examine the clearance of methotrexate (MTX) by high-flux hemodialysis (HD) in pediatric oncology patients. We present three patients who experienced nephrotoxicity and prolonged exposure to toxic MTX concentrations following high-dose infusions during treatment for osteogenic sarcomas. Each patient was successfully treated with high-flux HD, followed by carboxypeptidase G2 (CPDG2) in two cases. Minimal systemic toxicity occurred. We review the literature and discuss guidelines for early and aggressive treatment for this complication of high-dose MTX therapy. Clinically important removal of MTX depends upon prompt initiation of HD after detection of nephrotoxicity and delayed clearance of MTX. Therapy is indicated in cases where compassionate use of CPDG2 may not be available, or while awaiting its delivery.

KW - Antineoplastic-antimetabolites

KW - Bone neoplasms

KW - Hemodialysis

KW - Toxicology

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ER -

Effective removal of methotrexate by high-flux hemodialysis

Abstract

Keywords

ASJC Scopus subject areas

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