Incidence of drug-related deaths secondary to high-dose methotrexate and citrovorum factor administration.

A review of 498 patients treated with high-dose methotrexate (MTX) with citrovorum factor rescue revealed 29 drug-related deaths. Until the important factors in those deaths are identified, the use of high-dose MTX should be limited to institutions that possess the necessary supportive facilities and the ability to measure serum levels of the drug.