Related Experiment Video
Updated: Sep 23, 2025
04:48
Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
7.5K
Toxicity associated with high-dose intravenous methotrexate for hematological malignancies
Joel Wight1,2,3,4, Matthew Ku3,5, Melissa Garwood3
1Austin Health, Heidelberg, Australia.
Leukemia & Lymphoma
|May 16, 2022
Summary
High-dose methotrexate (HD-MTX) can cause kidney injury in patients with hematological malignancies. Higher doses (≥6 g/m²) and interacting drugs are key risk factors for this toxicity.
Area of Science:
- Oncology
- Pharmacology
- Nephrology
Background:
- High-dose methotrexate (HD-MTX) is essential for treating hematological malignancies.
- Predicting and preventing HD-MTX-induced kidney injury remains a clinical challenge.
Purpose of the Study:
- To identify risk factors for HD-MTX-related nephrotoxicity.
- To inform clinical decision-making for safer HD-MTX administration.
Main Methods:
- Retrospective analysis of 539 HD-MTX treatment episodes (≥1 g/m²) in 144 patients.
- Correlation of risk factors with clinically relevant nephrotoxicity (CTCAE v4.03 grade 2-4).
Main Results:
- Nephrotoxicity occurred in 7% of episodes, primarily grade 2.
- Doses ≥6 g/m² (HR 5.02) and co-administered nephrotoxic drugs (HR 7.15) were significant risk factors.
- Methotrexate levels, hypoalbuminemia, and age predicted prolonged clearance but not nephrotoxicity.
Conclusions:
- Key risk factors for HD-MTX nephrotoxicity are modifiable.
- This finding aids clinicians in managing HD-MTX toxicity and improving patient outcomes.
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