title: [Clinico-pharmacological studies on the course of high-dose methotrexate therapy in childhood. A retrospective comparison of centers].
abstract: In a retrospective study with comparison of two centres (Homburg and Munich) the response of 91 cycles of high-dose methotrexate treatment (4.2-13.6 g/m2 body-surface) was assessed in eight children with osteosarcoma and one with chondrosarcoma. Accompanying treatment (alkalization, infusion and leucovorin "rescue") was undertaken to reduce the methotrexate serum level 48 hours after infusion to below 0.4 mumol/l and thus avoid toxic effects. In the course of these treatment cycles there was a fall in urinary pH values below 7.0 in 59% (Homburg) and 75% (Munich) treatment cycles. On average there were lower methotrexate serum levels 24 and 48 hours after methotrexate administration among the Homburg patients than those in Munich. If urinary pH values fell to below 7.0, a decrease in leucocyte count below 2,000/mm3 was observed in 65% and 70%, respectively. The data indicate the need of carefully measuring urinary pH and methotrexate serum concentration during high-dosage methotrexate treatment and thus decrease the danger of bone-marrow damage.
mesh_terms: D000293:Adolescent; D001853:Bone Marrow / Q000187:drug effects; D001859:Bone Neoplasms / Q000188:drug therapy*; D002173:Cancer Care Facilities; D002648:Child; D002813:Chondrosarcoma / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D005860:Germany, West; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D012516:Osteosarcoma / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D008727:Methotrexate
vernacular_title: Klinisch-pharmakologische Untersuchungen zum Verlauf der hochdosierten Methotrexat-Therapie im Kindesalter. Ein retrospektiver Zentrenvergleich.