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Related Experiment Videos

Severe renal toxicity due to intermediate-dose methotrexate.

A N Stark1, G Jackson, P J Carey

  • 1Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, U.K.

Cancer Chemotherapy and Pharmacology
|January 1, 1989
PubMed
Summary

Severe toxicity from methotrexate (MTX) can occur even at intermediate doses, despite folinic acid rescue. Early recognition of loin pain is crucial for identifying patients at risk of renal damage.

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Area of Science:

  • Oncology
  • Pharmacology
  • Nephrology

Background:

  • Methotrexate (MTX) is a cornerstone chemotherapy agent for various cancers.
  • Common MTX toxicities include myelosuppression, mucositis, and renal damage, typically dose-dependent.
  • High-dose MTX ( > 1 g/m2) is associated with increased toxicity risk.

Observation:

  • This study details four cases of severe renal and mucosal toxicity.
  • Toxicity occurred at intermediate MTX doses (200 mg/m2) despite folinic acid rescue.
  • Three patients experienced severe loin pain shortly after MTX administration.

Findings:

  • Intermediate-dose MTX can lead to significant renal and mucosal toxicity.
  • Folinic acid rescue may not fully prevent toxicity in all cases.

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  • Severe loin pain is a potential early indicator of subsequent renal toxicity.

    • Implications:

    • Clinicians should consider MTX toxicity even at non-high doses.
    • Early identification of symptoms like loin pain can aid in prompt intervention.
    • Strategies to mitigate MTX-related toxicity require further investigation.