2012
DOI: 10.3109/10428194.2012.676177
|View full text |Cite
|
Sign up to set email alerts
|

Rational administration schedule for high-dose methotrexate in patients with primary central nervous system lymphoma

Abstract: Methotrexate (MTX) at a dose of ≥1 g/m(2) remains the most efficient treatment against primary central nervous system lymphoma (PCNSL), and is the most widely used drug in prospective clinical trials. MTX is a folate analog that inhibits dihydrofolate reductase, thereby blocking de novo purine synthesis. MTX as well as 7-hydroxy-MTX, its main metabolite in serum, are both eliminated by the kidneys. The elimination of MTX is prolonged in patients with renal impairment and third-space fluid collections, and in p… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
2
1
1
1

Citation Types

1
46
0
2

Year Published

2013
2013
2024
2024

Publication Types

Select...
9

Relationship

0
9

Authors

Journals

citations
Cited by 53 publications
(49 citation statements)
references
References 78 publications
1
46
0
2
Order By: Relevance
“…There is general consensus that MTX should be administered as a rapid infusion (2–4 hours) at a dose of at least 3 mg/m 2 to maximise therapeutic CSF concentrations, at an interval of 14–21 days [34]. Higher absolute MTX exposure (area under the plasma concentration-time curve, AUC MTX , >980–1,100 μmol · h/l) correlated with superior outcomes in two post-hoc and retrospective studies [35, 36], but these findings have not been reproduced in all studies [37].…”
Section: Treatmentmentioning
confidence: 99%
“…There is general consensus that MTX should be administered as a rapid infusion (2–4 hours) at a dose of at least 3 mg/m 2 to maximise therapeutic CSF concentrations, at an interval of 14–21 days [34]. Higher absolute MTX exposure (area under the plasma concentration-time curve, AUC MTX , >980–1,100 μmol · h/l) correlated with superior outcomes in two post-hoc and retrospective studies [35, 36], but these findings have not been reproduced in all studies [37].…”
Section: Treatmentmentioning
confidence: 99%
“…High-dose methotrexate (HDMTX) regimens, defined by MTX doses ≥ 1g/m2, and subsequent use of leucovorin to reduce toxicity, are used to treat a wide range of malignancies including lymphoma, breast carcinoma, sarcoma, and others [1-3]. Despite its broad application, the use of HDMTX is complicated by the risk of renal toxicity [4].…”
Section: Introductionmentioning
confidence: 99%
“…Based on the results of pharmacological and clinical studies, high-dose MTX for the treatment of CNS lymphoma is recommended, as a dose of at least 3 g/m 2 , over no longer than 3 h [15]. In this study, the dose of MTX was scheduled to be reduced from 5 to 3 g/m 2 , and it was further reduced in approximately 40% of patients due to advanced age, renal/hepatic dysfunction, or poor PS.…”
Section: Discussionmentioning
confidence: 99%