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Related Experiment Videos

Rescue from high-dose methotrexate with 5-methyltetrahydrofolate.

A Reggev, I Djerassi

    Cancer Treatment Reports
    |February 1, 1986
    PubMed
    Summary

    5-methyltetrahydrofolate (MTHF) effectively prevents toxicity from high-dose methotrexate (HDMTX) treatment. This study shows MTHF is a safe and effective rescue agent, comparable to citrovorum factor (CF), even at potentially fatal HDMTX doses.

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    Area of Science:

    • Oncology
    • Pharmacology
    • Biochemistry

    Background:

    • High-dose methotrexate (HDMTX) treatment requires rescue therapy to prevent toxicity.
    • 5-Formyl-tetrahydrofolate (citrovorum factor, CF) is a standard rescue agent.
    • 5-methyltetrahydrofolate (MTHF) is a downstream metabolite of CF, essential for thymidine synthesis.

    Purpose of the Study:

    • To evaluate the efficacy of MTHF as a rescue agent for HDMTX.
    • To assess MTHF's safety profile in patients receiving escalating doses of MTX.
    • To compare MTHF rescue with CF rescue.

    Main Methods:

    • Fifteen patients received 18 courses of escalating-dose MTX (1-24 g) followed by MTHF rescue.
    • Toxic effects were monitored.
    • A "matched pairs" comparison of CF and MTHF rescue was conducted in five patients.

    Main Results:

    • MTHF effectively prevented or reversed HDMTX toxicity, including leukopenia, thrombocytopenia, mucositis, nausea, vomiting, and elevated creatinine and transaminase levels.
    • All observed side effects were reversible, with full patient recovery.
    • MTHF demonstrated comparable rescue efficacy to CF in a "matched pairs" analysis.

    Conclusions:

    • MTHF is an effective and safe agent for preventing MTX toxicity, even at doses up to 24 g.
    • MTHF serves as a viable alternative to CF for methotrexate rescue therapy.

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