Continuous plasma resin perfusion for detoxification of methotrexate.
Acute renal failure is a rare but very severe side-effect of methotrexate (MTX) treatment requiring extracorporeal detoxification. A new detoxification regime, consisting of a haemodiafiltration (HDF) and continuous plasma resin perfusion (PRP) over anion exchange resin column with high affinity for MTX, was used for treatment of MTX-induced acute renal failure in a 2-year-old boy with medulloblastoma. More than 99% of MTX was removed from plasma by perfusion over the resin column resulting in a marked decrease of MTX plasma half-life. No haematological complications occurred.


CONCLUSIONS
The use of PRP alone or in combination with HDF is a new and effective treatment strategy for extracorporeal detoxification of MTX.
Greil
J
J
Klinik mit Poliklinik für Kinder und Jugendliche, University of Erlangen-Nürnberg, Germany.
Wyss
P A
PA
Ludwig
K
K
Bonakdar
S
S
Scharf
J
J
Beck
J D
JD
Ruder
H
H
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000493:pharmacokinetics; D002675:Child, Preschool; D017583:Hemodiafiltration; D006801:Humans; D007475:Ion Exchange Resins; D008297:Male; D008657:Metabolic Clearance Rate; D008727:Methotrexate / Q000009:adverse effects* / Q000493:pharmacokinetics; D016060:Sorption Detoxification / Q000379:methods*
D000964:Antimetabolites, Antineoplastic; D007475:Ion Exchange Resins; D008727:Methotrexate