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Premium METHOTREXATE IN THE PLASMA AND CEREBROSPINAL FLUID OF CHILDREN TREATED WITH INTERMEDIATE DOSE METHOTREXATE
Author(s)
RECHNITZER CATHERINE,
SCHEIBEL ELMA,
HENDEL JØRN
Publication year1981
Publication title
acta pædiatrica
Resource typeJournals
PublisherBlackwell Publishing Ltd
ABSTRACT. Rechnitzer, C, Scheibel, E. and Hendel, J. (University Clinic of Paediatrics, Rigshospitalet and Department of Clinical Chemistry, Finsen Institute, Copenhagen, Denmark). Methotrexate in the plasma and cerebrospinal fluid of children treated with intermediate dose methotrexate. Acta Paediatr Scand, 70:615,.–Serious complications can follow treatment with intermediate dose methotrexate of acute lymphoblastic leukemia in childhood. Toxicity has been shown to be correlated to plasma methotrexate concentrations. During intravenous infusions of methotrexate (500 mg/m 2 ) the mean concentrations achieved 1 to 4 1 / 2 hours after the start of infusion were 1.3×10 ‐7 mol/l in cerebrospinal fluid and 1.7×10 ‐5 mol/1 in plasma. At 72 hours after start of methotrexate infusion, plasma methotrexate concentrations were significantly higher in cases with symptoms of toxicity. In all the children who developed toxic symptoms 72‐hour plasma methotrexate concentration was above 1×10 ‐7 mol/l. Assuming that leucovorin is given 48 hours after the start of methotrexate infusion, 72‐hour plasma methotrexate is suitable for detection of patients at risk for toxicity. In children treated with intermediate dose methotrexate we therefore recommend estimating plasma methotrexate concentration 72 hours after the start of infusion, and instituting supplementary leucovorin when plasma methotrexate concentration exceeds 1×10 ‐7 mol/l.
Subject(s)anesthesia , antimetabolite , cerebrospinal fluid , chemotherapy , gastroenterology , medicine , methotrexate , pharmacology , plasma concentration , toxicity
Language(s)English
SCImago Journal Rank0.772
H-Index115
eISSN1651-2227
pISSN0803-5253
DOI10.1111/j.1651-2227.1981.tb05755.x

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