title: [Toxicity of high dose methotrexate repeated infusions in children treated for acute lymphoblastic leukemia and osteosarcoma].
abstract: We evaluated and compared hematologic, hepatic and renal cumulative toxicity of high dose methotrexate (HDMTX) repeated courses in two groups of pediatric patients: 22 patients affected by "non B" acute lymphoblastic leukemia (ALL) treated, in consolidation phase, with four courses of HDMTX 5 g/mq given intravenously over 24 hours infusion (for a total of 88 courses) according to the Italian Cooperative Protocols AIEOP LLA-88; 18 patients affected by non metastatic osteosarcoma of extremities (OST) treated, in preoperative and postoperative phases, with five courses of HDMTX 8 g/mq given intravenously over 6 hours infusion (for a total of 90 courses) according to CNR-NEO 2 protocol. Severe myelosuppression (neutropenia < 500/microliters and/or thrombocytopenia < 25000/microliters) was more frequently observed in ALL (7% of infusions) than in OST (3%). Hepatotoxicity (serum transaminase elevation > 350 IU/l) was significantly more frequent (p < 0.001) in OST (32% of courses) than ALL (6%). Nephrotoxicity was assimilable in the two groups and the elevation of serum creatinine was never higher than 1.9 mg/dl. We did not observe any increase of hematologic, hepatic and renal toxicity following the HDMTX courses repetition.
authors.affiliation: Dipartimento di Scienze Pediatriche e dell'Adolescenza, Universitá degli Studi, Torino.
authors.forename: L
authors.initials: L
authors.lastname: Ridolfi
authors.forename: E
authors.initials: E
authors.lastname: Barisone
authors.forename: M
authors.initials: M
authors.lastname: Vivalda
authors.forename: C
authors.initials: C
authors.lastname: Vivenza
authors.forename: A
authors.initials: A
authors.lastname: Brach Del Prever
authors.forename: L
authors.initials: L
authors.lastname: Leone
authors.forename: R
authors.initials: R
authors.lastname: Miniero
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects; D008099:Liver / Q000187:drug effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D009503:Neutropenia / Q000209:etiology; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000473:pathology; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D008727:Methotrexate