Safety analysis of high-dose methotrexate in pediatric non-Hodgkin lymphomas.

Safety analysis of high-dose methotrexate in pediatric non-Hodgkin lymphomas.
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DOI:
10.1002/pbc.29940
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发表时间:
2022-11
影响因子:
3.2
通讯作者:
--
中科院分区:
医学3区
文献类型:
--
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高剂量甲氨蝶呤(HD-MTX)配合严格的支持性治疗对于儿童非霍奇金淋巴瘤(NHL)的治疗至关重要。我们描述了HD-MTX在我们中心治疗的NHL患者中的安全性和耐受性。在我们的46例患者队列中,大多数患者至少有一个疗程的延迟清除和/或肌酐升高。此外,超过三分之一的患者经历≥3级粘膜炎发作。肌酐升高和延迟清除与随后的≥3级粘膜炎独立相关。我们提倡加强甲氨蝶呤监测,以便在世界范围内扩大这一基本治疗方式的剂量。
High-dose methotrexate (HD-MTX) with rigorous supportive care is essential to the treatment of pediatric non-Hodgkin lymphomas (NHL). We describe the safety and tolerability of HD-MTX in patients with NHL treated at our center. In our cohort of 46 patients, the majority had at least one course of delayed clearance and/or creatinine elevation. Additionally, more than one-third of patients experienced an episode of grade ≥3 mucositis. Creatinine elevations and delayed clearance were independently associated with subsequent grade ≥3 mucositis. We advocate for greater availability of methotrexate monitoring to allow dose escalation of this essential modality around the world.
DOI: 10.1056/nejmoa1915315
发表时间: 2020-06-04
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