Effect of charcoal hemoperfusion for removal of plasma methotrexate in a patient with acute renal failure.
Strategies effective for accelerating methotrexate removal in delayed methotrexate excretion have not been universally accepted. The authors report a case of a 12-year-old girl with osteosarcoma who developed acute renal failure immediately after the first administration of high-dose methotrexate. Plasma methotrexate was effectively removed with repeated charcoal hemoperfusion in addition to plasma exchange and leucovorin rescue. Charcoal hemoperfusion was most effective for reducing plasma methotrexate with approximately 50% of methotrexate being reduced during each of the procedures. No rebound increase in MTX levels was observed. The patient received further therapy with other cancer drugs and has been well for 3.5 years.
Nemoto
Tae
T
Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Imai
Chihaya
C
Kaneko
Utako
U
Takachi
Takayuki
T
Iwabuchi
Haruko
H
Tanaka
Atsushi
A
Nakamura
Gen
G
Ogose
Akira
A
Uchiyama
Makoto
M
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000097:blood / Q000188:drug therapy; D002606:Charcoal; D002648:Child; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D012516:Osteosarcoma / Q000097:blood / Q000188:drug therapy; D011884:Radius
D000964:Antimetabolites, Antineoplastic; D002606:Charcoal; D008727:Methotrexate