Krackhardt A, Schwartz S, Korfel A, Thiel E
Medizinische Klinik III, Hämatologie, Onkologie und Transfusionsmedizin, Freie Universität Berlin, Universitäsklinikum Benjamin Franklin, Germany.
Leuk Lymphoma. 1999 Nov;35(5-6):631-5. doi: 10.1080/10428199909169631.
A 79 year-old female patient presented with immunoblastic B-cell lymphoma of the ethmoidal sinuses and destruction of the anterior cranial fossa. After 3 cycles of high-dose methorexate (HD-MTX) MTX serum level remained elevated and creatinine serum levels raised. The patient received Carboxypeptidase G2 (CPG2) intravenously. Within one hour the MTX serum level decreased to <1 micromol/l as determined by high pressure liquid chromatography (HPLC). The patient recovered without significant toxicity and attained a long lasting ongoing (>14 months) complete remission. In this case we were able to demonstrate that rescue from HD-MT nephrotoxicity by CPG2 is also safe and effective in patients with advanced age with impaired renal function. With the help of CPG2, sufficient and potentially curative therapy with HD-MTX may also be provided to patients with a high risk of renal failure.
一名79岁女性患者被诊断为筛窦免疫母细胞性B细胞淋巴瘤，伴有前颅窝破坏。在接受3个周期的大剂量甲氨蝶呤（HD-MTX）治疗后，甲氨蝶呤血清水平持续升高，肌酐血清水平也升高。患者接受了静脉注射羧肽酶G2（CPG2）治疗。通过高压液相色谱法（HPLC）测定，在1小时内甲氨蝶呤血清水平降至<1微摩尔/升。患者康复且无明显毒性反应，并获得了持续时间较长（>14个月）的完全缓解。在本病例中，我们能够证明，对于肾功能受损的老年患者，CPG2挽救HD-MT所致肾毒性也是安全有效的。借助CPG2，也可为有肾衰竭高风险的患者提供足够的、有可能治愈的HD-MTX治疗。
