Prospective evaluation of the toxicity profile, and predictors of toxicity of high dose methotrexate in patients of acute lymphoblastic leukemia/lymphoma

Tiwari, Prateek; Ganesan, Prasanth; Radhakrishnan, Venkatraman; Arivazhagan, R; Ganesan, Trivadi S.; Dhanushkodi, Manikandan; Totadri, Sidharth; Sagar, Tenali Gnana

doi:10.1016/j.phoj.2018.01.003

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Relations between clinical response and systematic toxicity after MTX treatment and gene variation in the Figure 4. DFS in Relation to cyclin D1 Variant folate metabolic pathway have been detected many times Most studies have focused on MTHFR C677T and RFC G80A and suggested that these polymorphisms contribute to MTX therapy-related toxicity or outcome of childhood ALL (Umerez et al, 2017, Tiwari et al, 2018.…”

Section: Discussionmentioning

confidence: 99%

Cyclin D1 G870A Polymorphism: Relation to the Risk of ALL Development, Prognosis Impact, and Methotrexate Cytotoxicity

Menshawy

Marghany

Sarhan

et al. 2020

Asian Pac J Cancer Prev

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Nowadays, Pharmacogenomics tests, including Genome-wide association studies (GWAS), have a direct identification role in genetic alterations, treatment efficacy, cytotoxicity, prognosis, etc. However, the current knowledge gives little data about how genomic determinants can affect ALL susceptibility, chemotherapy, and chance of relapse (Wu and Li, 2018). Methotrexate (MTX) forms the backbone of maintenance cycles in childhood acute lymphoblastic leukemia (ALL) chemotherapy, including interim maintenance (Mandal et al., 2020). Major adversities include cytopenias, mucositis, liver toxicity, renal toxicity and skin toxicity. These toxicities enquire dose modification or omission (burn out) MTX-related toxicities may be determined by several factors like dose, duration, genetic susceptibility and risk factors (Vaishnavi et al ., 2018).

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Section: Discussionmentioning

confidence: 99%

Cyclin D1 G870A Polymorphism: Relation to the Risk of ALL Development, Prognosis Impact, and Methotrexate Cytotoxicity

Menshawy

Marghany

Sarhan

et al. 2020

Asian Pac J Cancer Prev

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“…Moreover, there are very limited efforts to monitor drug levels in Indonesia. Studies have indicated that the number of cycles and the MTX dosage administered is lower (< 1g/m 2 ) in the protocols of developing countries, including in Indonesia, which may lead to less effective treatment (Ferdousi et al, 2017;Agnes et al, 2 018;Tiwari et al, 2018).…”

Section: Research Articlementioning

confidence: 99%

Monitoring Of High-Dose Methotrexate (Mtx)-Related Toxicity and Mtx Levels in Children with Acute Lymphoblastic Leukemia: A Pilot-Study in Indonesia

Sari

Rakhmilla

Bashari

et al. 2021

Asian Pac J Cancer Prev

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“…A study from Cancer Institute, Chennai, showed that 42 h methotrexate levels predicted delayed clearance and toxicity. [11] Change in the creatinine from the baseline after HDMTX predicts hematologic toxicity. [12] HDMTX up to 5 g/m 2 can be safely administered without monitoring of methotrexate levels by extended hydration, additional leucovorin, and monitoring of serum creatinine and urine pH.…”

Section: Toxicitymentioning

confidence: 99%

High-dose methotrexate

Dhanushkodi

2019

Indian J Med Paediatr Oncol

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High-dose methotrexate (HDMTX) is defined as methotrexate dose of ≥500 mg/m 2 . It is used in the treatment of acute lymphoblastic leukemia, osteosarcoma, and primary central nervous system lymphoma. Administration mandates adequate hydration; urine alkalinization; leucovorin rescue, monitoring of urine output, serum creatinine, and methotrexate levels. Delayed methotrexate clearance is managed by increasing hydration and leucovorin dose. Glucarpidase is the antidote for patients with renal toxicity. Studies from India have shown that HDMTX can be administered without monitoring of methotrexate levels with strict monitoring of urine pH, urine output, and serum creatinine and extended hydration and leucovorin doses.

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Prospective evaluation of the toxicity profile, and predictors of toxicity of high dose methotrexate in patients of acute lymphoblastic leukemia/lymphoma

Cited by 4 publications

References 23 publications

Cyclin D1 G870A Polymorphism: Relation to the Risk of ALL Development, Prognosis Impact, and Methotrexate Cytotoxicity

Cyclin D1 G870A Polymorphism: Relation to the Risk of ALL Development, Prognosis Impact, and Methotrexate Cytotoxicity

Monitoring Of High-Dose Methotrexate (Mtx)-Related Toxicity and Mtx Levels in Children with Acute Lymphoblastic Leukemia: A Pilot-Study in Indonesia

High-dose methotrexate

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