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Related Experiment Video

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High-throughput Fluorometric Measurement of Potential Soil Extracellular Enzyme Activities
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[Not Available].

Hélène Blasco1, Stéphanie Silly1, Jean-François Tournamille2

  • 1Laboratoire de Pharmacologie et Toxicologie, CHRU Bretonneau, Tours, France.

Therapie
|July 10, 2016
PubMed
Summary
This summary is machine-generated.

High dose methotrexate (HD-MTX) can cause toxicity. This study suggests refining carboxypeptidase use criteria to MTX levels >10 μM with renal impairment, improving patient outcomes and managing treatment costs.

Keywords:
carboxypeptidaseglucarpidasehigh-dose methotrexateinsuffisance rénalemethotrexate overexposureméthotrexate à haute doserenal failuresurexposition au méthotrexate

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Area of Science:

  • Oncology
  • Pharmacology
  • Nephrology

Context:

  • High-dose methotrexate (HD-MTX) is a critical chemotherapy agent.
  • HD-MTX administration can lead to significant non-hematological and hematological toxicities.
  • MTX overexposure, often due to administration errors or renal impairment, necessitates prompt intervention.

Purpose:

  • To retrospectively evaluate the application of current carboxypeptidase (MTX rescue) use criteria.
  • To identify patients who met criteria for carboxypeptidase but did not receive it.
  • To analyze the toxicities experienced by these patients.

Summary:

  • Patients with MTX concentrations at H48 ≥ 3 μM or impaired renal function were assessed.
  • Twenty of 301 courses (7%) and 18 of 120 patients met at least one criterion.
  • Grade 3-4 toxicity occurred in 30% of courses, including severe acute kidney injury; most renal function recovered within 3 months.

Impact:

  • Current criteria for carboxypeptidase use may be too broad, leading to unnecessary treatment.
  • Refining criteria to MTX H48 concentrations >10 μM combined with renal impairment could optimize carboxypeptidase use.
  • This optimization may reduce treatment costs while ensuring effective management of MTX toxicity.