Study On Chemotherapeutic
Individualization of High-dose Methotrexate in Childhood Acute
Lymphoblastic Leukemia
Ye Hui, Gu Longjun, Chen Jing, Xue
Huiliang, Tang Jingyan, Zhao Huijun, Bian Jinguo, Pan Ci, Zhang Li
Shanghai Children’s Medical Center, Shanghai Second
Medical University, Shanghai, China
Objective:
To
observe the steady state plasma concentrations (Css) and side effects with
two different dosages of high-dose methotrexate (MTX) by continuous
intravenous injection for 24 hours.
Methods: 2-milliliter blood
samples were collected at 1,6,23,44,68 hours beginning the MTX-infusion.
The levels of MTX were measured by the fluorescence polarization
immunoassay (FPIA).
Results: The levels of MTX in 17
patients given 3 g m-2 each time
at 1,6,23,44,68 hours beginning the MTX-infusion were 53.83±14.77mmol L-1, 30.46±7.06mmol L-1, 35.19±9.76mmol L-1, 0.91±1.34mmol L-1, 0.25±0.28mmol L-1,
respectfully. The concentrations in 7 patients given 5 g m-2 each time
were 64.83±20.13mmol L-1, 42.33±10.06mmol L-1, 49.28±11.75mmol L-1, 1.71±2.11mmol L-1, 0.45±0.98mmol L-1,
respectfully. The next course of chemotherapy was delayed in 4 patients for
severe side effects.
Conclusion: The current data
indicate that the Css of MTX could achieve optimal intracellular accumulation
of MTX polyglutamates (MTXPGs) which the standard and high risk ALL
required, and the side effects were acceptable.