[High-dose methotrexate therapy in osteogenic sarcoma: plasma pharmakokinetics to predict toxicity (author's transl)].
In 22 patients with osteogenic sarcoma, treated with 103 high-dose methotrexate infusions (6-8.5 g/m2 in 4-6 h) plasma methotrexate levels were measured with a specific and rapid radioimmunoassay. Nontoxic infusions were associated with methotrexate concentrations below 8.0 X 10(-6) mol/l at 24 h, 8.0 X 10(-7) mol/l at 48 h and 4.25 X 10(-7)/mol/1 at 72 h. All patients with 48 h methotrexate levels above 1 X 10-6 mol/l manifested severe toxicity with myelosuppression and stomatitis due to delayed methotrexate excretion. Rise of serum creatinine was not reliable to predict oxicity. Determination of 48- and 72-h methotrexate concentrations proved to be a valuable method for identifying patients at high risk for toxic side effects. Additional citrovorum factor may thus be given in time.
D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000187:drug effects; D001859:Bone Neoplasms / Q000188:drug therapy*; D002648:Child; D003404:Creatinine / Q000097:blood; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D012516:Osteosarcoma / Q000188:drug therapy*; D011863:Radioimmunoassay / Q000379:methods; D013280:Stomatitis / Q000139:chemically induced
D003404:Creatinine; D002955:Leucovorin; D008727:Methotrexate
Hochdosierte Methotrexattherapie beim osteogenen Sarkom: Plasmapharmakokinetik zur Vorhersage der Toxizität.