Correlation between Acute Drug-induced Liver and Kidney Injury and HD-MTX Blood Concentration in Patients with Osteosarcoma
10.3969/j.issn.1008-049X.2018.06.030
- VernacularTitle:56例骨肉瘤患者使用大剂量甲氨蝶呤血药浓度与其急性肝肾损伤的相关性研究
- Author:
Xinchen WANG
1
;
Yancai SUN
Author Information
1. 安徽省肿瘤医院药剂科 合肥230031
- Keywords:
Osteosarcoma;
HD-MTX;
Drug-induced liver injury;
Drug-induced kidney injury;
Blood drug concentration
- From:
China Pharmacist
2018;21(6):1064-1066
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the correlation between HD-MTX blood concentration and acute drug-induced liver and kidney injury in the patients with osteosarcoma, and investigate the significance of HD-MTX concentration in the monitoring of liver and kidney toxicity. Methods: A total of 56 osteosarcoma patients treated with HD-MTX were selected, and after HD-MTX treatment, the blood concentration of MTX was detected by an HPLC-UV method in 48 h and 72 h after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentrations of MTX and the change of liver and kidney func-tion was analyzed. Results: All the patients were monitored MTX blood concentration at different time points. After the 48-hour HD-MTX treatment, 4 patients (7. 14% ) were with acute drug-induced liver injury and 13 patients (23. 21% ) showed drug-induced kid-ney injury. The average C48hof liver injury was (2.90 ±0.78) μmol·L-1, and the average C48hof kidney injury was (1.65 ±1.12) μmol·L-1. After the 72-hour HD-MTX treatment, 7 patients ( 12. 50% ) were with drug-induced liver injury and 16 patients (28.57%) showed drug-induced kidney injury. The average C72hof liver injury was (0.30 ±0.17) μmol·L-1, while the average C48hof kidney injury was (0. 29 ± 0. 29) μmol·L-1. The function indices of liver ( ALT, ALP and TBIL) and kidney ( SCr) were significantly higher than those in the normal group (P<0. 05), and the blood concentration of MTX was partly significantly correlated with those indicators. Conclusion: There is a certain correlation between MTX induced injury and the blood drug concentration at par-ticular points, and C48hmay be more valuable to predict drug-induced liver and kidney injury.
