High Dose Methotrexate Induced Toxicity in Children with Hematological Malignancy: Incidence and Relation to MTX Level | ||||
| SECI Oncology Journal | ||||
| Volume 12, Issue 4, October 2024, Page 388-394 | ||||
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| Abstract | ||||
| Background: Methotrexate is an effective drug for the treatment of malignant hematopoietic neoplasm in children; its antineoplastic activity is enhanced when MTX is used at high dose. Monitoring of patient after high dose methotrexate administration is essential to manage toxicity. Aim of the work: Incidence of HDMTX toxicity in children with hematological malignancies and relation to MTX level. Patients & Methods: A prospective study conducted on 142 patients with hematological malignancies who received 467 cycles of HDMTX scheduled in their treatment protocols during the period from May 2020 to September 2022, assessment of the patients before HDMTX administration and after the dose to detect any toxicities. Results: GIT toxicity reported in 434 (92.9%) followed by renal toxicity in form of raised serum creatinine in 114 (24.4%), hepatic toxicity in 51 (10.9%) and myelosuppression in 48 (10.3%). Toxic MTX level at 23h & 66h significantly associated with increased creatinine level. In addition, Toxic MTX level at 23h significantly associated with all systems and GIT toxicities. MTX level at 42h didn’t show any significant relations Conclusion: GIT toxicities are the most common HDMTX toxicities and related to high 23 h MTX level. Both high 23h & 66 h MTX level are good indicators of renal toxicities. | ||||
| Keywords | ||||
| Hematological malignancies; HDMTX; Pediatrics; Toxicity; MTX level | ||||
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