Blood purification therapies of hypermethotrexemia
10.3760/cma.j.issn.1673-4912.2019.01.001
- VernacularTitle:高甲氨蝶呤血症的血液净化治疗
- Author:
Xinlei JIA
1
;
Suyun QIAN
Author Information
1. 首都医科大学附属北京儿童医院重症医学科 100045
- Keywords:
High-dose methotrexate;
Blood purification;
Children
- From:
Chinese Pediatric Emergency Medicine
2019;26(1):1-4
- CountryChina
- Language:Chinese
-
Abstract:
Methotrexate ( MTX) is administered at a high dose for the treatment of diseases such as leukemia and malignant lymphoma. However, it will cause serious adverse reactions such as acute kidney injury,myelosuppression, and mucositis. On the basis of hydration alkalization and high-dose leucovorin rescue in children with high risk of MTX poisoning,blood purification should be performed as soon as possi-ble to clear MTX. The number and frequency of hemodialysis should be determined according to the general condition of the child,the degree of renal injury and the concentration of MTX,and high-throughput hemodi-alysis can be selected if available. Continuous renal replacement therapy is suitable for children with hemodynamic instability. When the MTX concentration is extremely high, it is recommended to combine hemoperfusion and hemodialysis to achieve better clearance.
