[Toxicosis of high-dose methotrexate (HD-MTX) for osteosarcoma, cured with treatment by leucovorin (LV) rescue and hemoperfusion--a case report].
A 17-year-old boy suffered from osteosarcoma in his left distal femur. He was treated with 4 courses of HD-MTX preoperatively, then a wide resection and replacement with endprosthesis was performed. After surgery, 4 more courses of HD-MTX were administered. In the last course of HD-MTX, the serum level of MTX had not decreased to a safe level after 48 hours following MTX administration. Liver and renal dysfunction then occurred, so massive leucovorin rescue and hemoperfusion were done. Fortunately, all complications disappeared. The patient is alive and well, and has been disease free for six years since surgery.
Kobayashi
H
H
Division of Orthopedic Surgery, Niigata Cancer Center Hospital.
Morita
T
T
Hirata
Y
Y
Kato
T
T
Okada
Y
Y
Sato
T
T
D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee; D003131:Combined Modality Therapy; D005266:Femoral Neoplasms / Q000628:therapy*; D006464:Hemoperfusion; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D012516:Osteosarcoma / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage
D000964:Antimetabolites, Antineoplastic; D014750:Vincristine; D002955:Leucovorin; D008727:Methotrexate