Incidence and management of patients with methotrexate delayed elimination in the clinical practice

High-dose methotrexate (HDMTX) is administered for the treatment of some cancers. HDMTX is usually safe but may crystallize in renal tubules causing acute kidney injury (AKI). Consequently, MTX elimination is delayed, resulting in a severe and life-threatening condition. No studies have been publish...

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Detalles Bibliográficos
Autores: Gros, Luis, Roldán-Pérez, Alicia|||0000-0003-1151-5678, Cabero-Martínez, Almudena, Domínguez-Pinilla, Nerea, De la Fuente, Adolfo, González Barca, Eva|||0000-0002-1323-1508, Tasso, María, Torrent, Montserrat|||0000-0003-1917-1056, Gallardo, Eva, del Cerro, Inés, Giró-Perafita, Ariadna, Badia, Xavier|||0000-0001-7568-2550
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:301683
Acceso en línea:https://ddd.uab.cat/record/301683
https://dx.doi.org/urn:doi:10.1177/10781552221079568
Access Level:acceso abierto
Palabra clave:High-dose methotrexate
Acute kidney injury
Clinical management
Epidemiology
Methotrexate delayed elimination
Descripción
Sumario:High-dose methotrexate (HDMTX) is administered for the treatment of some cancers. HDMTX is usually safe but may crystallize in renal tubules causing acute kidney injury (AKI). Consequently, MTX elimination is delayed, resulting in a severe and life-threatening condition. No studies have been published about the impact of MTX toxicity in Spain. This study aims to estimate the incidence and management of MTX delayed elimination and toxicity. A two-round Delphi study was performed to reach consensus between 10 medical experts on haemato-oncology and paediatric oncology with experience in the management of HDMTX treated patients from leading Spanish hospitals. An online questionnaire was developed based on national and international guidelines and previous evidence regarding HDMTX-related toxicity. Consensus was established at 80% agreement. Median and interquartile ranges were calculated, and incidence data were extrapolated to the Spanish general population. Out of 1.475 patients estimated to receive HDMTX treatment annually in Spain, 27.5% present MTX delayed elimination and 11.6% develop HDMTX-induced AKI (35.4% with severe systemic toxicities (.

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