Analysis of delayed elimination after repeated high-dose chemotherapy of methotrexate
10.13699/j.cnki.1001-6821.2018.03.052
- VernacularTitle:大剂量甲氨蝶呤多次化疗后出现消除延迟的病例分析
- Author:
Yan SONG
1
;
Jin-Ju DUAN
;
Miao-Xin JIA
;
Qiang ZHAO
;
Rui-Gang HOU
Author Information
1. 山西医科大学第二医院药学部
- Keywords:
methotrexate;
blood drug concentration;
delayed elimination
- From:
The Chinese Journal of Clinical Pharmacology
2018;34(3):359-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the condition of delayed elimination occurred on a patient with acute B lymphocytic leukemia after the forth time of high-dose methotrexate (MTX) chemotherapy and to analyze its reasons.Methods Reviewed the patient's relevant data during the four times of high-dose chemotherapy,including the therapeutic regimen,the results of therapeutic drug monitoring,and other relevant laboratory reports etc.What's more,consulted some related literature,further analyzed the reason of delayed elimination appeared on the patient after repeated chemotherapy of MTX in different views.Results The patient hadn't suffered the MTX relevant adverse reactions after the rescue drug therapy by calcium folinate etc.The blood concentration of MTX decreased to 0.10 μmol · L-1 after 216 hours of administration.It was suggested that the pH of the patient's urine was the possible reason influencing the elimination of MTX,but the foods,the cycles of chemotherapy and the disease stage also couldn't be excluded.Conclusion The blood drug concentration in the different cycles of MTX therapy for the patient were not same,and its specific mechanism needs an in-depth study.If the delayed elimination of MTX occurred,the rescue should be strengthened to ensure the safety and effectiveness of patients.
