[Evaluation of methotrexate levels in biological fluids released from bone cement filling]

The authors present an analysis of methotrexate concentration in blood, urine and drainage liquid (both deep and superficial), as well as the results of biochemical analysis of blood and urine in a population of 42 patients treated surgically because of pathologic fractures of long bones. In 8 of the 42 patients chemotherapy was applied 14 days before the surgical procedure. Lithic lesions in the long bones were filled with cement with 2 g of methotrexate and further stabilisation was achieved by applying metal implants. The highest methotrexate concentrations were noted in deep drainage fluid and in blood. Methotrexate concentration reached its peak in body fluids 12-24 hours after the procedure, and fell to a minimum 48-72 hours post surgery. The lowest level of the drug compared to all body fluids was found to be in the blood. Only after 72 hours did it exceed the minimum required level of 0.05 umol/l. All biochemical markers in blood and urine except AspAT were found within normal range in all cases 72 hours post surgery. After 24-72 hours post-op a decrease in the number morphotic elements of blood was noted, particularly lymphocytes and thrombocytes.