Analysis of related factors affecting delayed excretion of methotrexate in high-dose methotrexate chemotherapy regimen for osteosarcoma patients
10.13699/j.cnki.1001-6821.2023.24.010
- VernacularTitle:骨肉瘤患者大剂量甲氨蝶呤化疗方案中影响甲氨蝶呤排泄延迟的相关因素分析
- Author:
Qiao-Yan LI
1
;
Ai-Ling MA
;
Yi-Meng WANG
;
Dan YANG
;
Xiao-Meng CHEN
;
Ci CHEN
;
Ning-Min ZHAO
Author Information
1. 河南省人民医院药学部,河南郑州 450003
- Keywords:
osteosarcoma;
high dose methotrexate;
elimination delay;
albumin
- From:
The Chinese Journal of Clinical Pharmacology
2023;39(24):3589-3592
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors that affect the excretion rate of methotrexate and the occurrence of adverse reactions in high-dose methotrexate chemotherapy for osteosarcoma patients.Methods Retrospectively analyzed methotrexate excretion,liver injury,kidney injury,bone marrow suppression and other adverse drug reactions in 97 high-dose methotrexate chemotherapy cycles of 28 patients with osteosarcoma.The concentration of methotrexate in the blood at 0,24,48,72 h and the level of white protein in the blood were also analyzed.Results When the peak concentration of methotrexate(0h,Cmax)≥700 μmol·L-1 the risk of excretion delay increases:the incidence was 23.21％in group with Cmax ≥ 700 μmol·L-1,and it was 5.00％in group with Cmax＜700 μmol·L-1,(P＜0.05),but when the peak concentration was≥1 000 μmol·L-1,the risk of delayed excretion did not increase further:the incidence was 16.00％in group with Cmax 1 000 μmol·L-1,and it was 15.49％in group with Cmax＜1 000 μmol·L-1,(P＞0.05).Methotrexate blood Cmax has no significant correlation with the occurrence of important adverse reactions such as liver injury and bone marrow suppression.There was significant correlation between low serum albumin level and bone marrow suppression in patients.The average albumin level in group with bone marrow suppression was(39.1±3.4)g·L-1,which in without bone marrow suppression group was(41.2±4.0)g·L-1(P＜0.05).Conclusion During high-dose methotrexate chemotherapy in patients with osteosarcoma,delayed excretion and adverse reactions should not be prevented by lowering the peak concentration.The albumin level of patients is an important factor affecting the occurrence of bone marrow suppression.
