[Blood concentration monitoring during high-dose methotrexate treatment].
OBJECTIVE
To explore the clinical value of blood concentration monitoring during high-dose methotrexate (MTX) treatment.


METHODS
High-dose MTX (1.5-9.0 g) was infused to 105 patients with acute lymphoblastic leukemia or lymphoma, and then the blood MTX concentration was measured by fluorescence polarization immune assay (FPIA) 44 hours after the start of administration. The procedure was repeated every 6-12 hours until the concentration was less than 0.1 micromol/L.


RESULTS
Forty-four hours after the start of administration, the blood MTX concentration (C(MTX/44h)) was > or = 5 micromol/L in 6 patients (2.8%) and was between 1 and 5 micromol/L in 23 patients (10.6%). C(MTX/44h) > or = 1 micromol/L was more common in patients received 5.0 g MTX. No severe adverse event was observed in all patients.


CONCLUSIONS
Blood MTX concentration is different after high-dose MTX treatment due to individual metabolic differences, and therefore it is clinically important to monitor blood concentration of MTX. Elimination delay is more common in patients receive 5.0 g MTX. Application of high-dose MTX therapy under the monitoring of blood MTX concentration is safe and feasible.
Jiao
Li
L
Department of Hematology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhou
Dao-Bin
DB
Wang
Shu-Jie
SJ
Zhang
Wei
W
Duan
Ming-Hui
MH
Li
Jian
J
Han
Bing
B
Xu
Ying
Y
Zhao
Yong-Qiang
YQ
Shen
Ti
T
Wang
Qiang
Q
Ye
Min
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D055815:Young Adult
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate