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What Is the Expected Clearance of Methotrexate? A Therapeutic Drug Monitoring Reference Guide for High‐Dose Methotrexate Use in Pediatric Malignancies
Author(s) -
Taylor Zachary L.,
Miller Tamara P.,
Board Sarah G.,
Poweleit Ethan A.,
Chavana Ashley,
Weisnicht Allison,
Brown Austin L.,
Bernhardt Melanie B.,
Schafer Eric S.,
O'Brien Maureen M.,
Castellino Sharon M.,
Ramsey Laura B.
Publication year - 2025
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.31744
Subject(s) - methotrexate , medicine , therapeutic drug monitoring , pharmacokinetics , drug , lymphoma , pharmacology , leukemia , serum concentration , oncology , intensive care medicine
ABSTRACT High‐dose methotrexate dosage and infusion durations differ across treatment protocols for pediatric leukemia, lymphoma, and osteosarcoma. Supportive care interventions are dependent on a patient's elimination of methotrexate (MTX). Therefore, it is important to establish the expected MTX elimination across protocols. Using modeling and simulation of real‐world data, we determined the expected MTX concentrations at common time points from the start of infusion (24, 36, 42, 48, 60, and 72 hours) and the time that each patient would reach a typical discharge threshold (0.4, 0.2, 0.15, and 0.10 µM). These data provide a reference for MTX concentrations for common pediatric protocols.