Plasma methotrexate levels in patients receiving etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine (EMA-CO) chemotherapy for trophoblastic neoplasia.
Methotrexate serum levels were measured in eight patients receiving etoposide, methotrexate, actinomycin, cyclophosphamide, and oncovin (EMA-CO) chemotherapy for high-risk and actinomycin-resistant gestational trophoblastic neoplasia. During 41 courses of EMA there were only 3 instances where the level of methotrexate was greater than 9 x 10(-7) M/liter at 24 hr postinfusion. A level higher than this may be associated with subsequent toxicity. Use of postmethotrexate leucovorin rescue should continue, but routine measurement of methotrexate with EMA-CO is unnecessary unless there is compromise of renal or hepatic function.
Kohorn
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Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D014750:Vincristine / Q000008:administration & dosage
D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate