儿童非霍奇金淋巴瘤中甲氨蝶呤大剂量治疗的安全性分析。
Safety analysis of high-dose methotrexate in pediatric non-Hodgkin lymphomas.
机构信息
Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, Texas, USA.
Texas Children's Hospital, Texas Children's Cancer and Hematology Centers, Houston, Texas, USA.
出版信息
Pediatr Blood Cancer. 2022 Nov;69(11):e29940. doi: 10.1002/pbc.29940. Epub 2022 Sep 7.
Abstract
High-dose methotrexate (HD-MTX) with rigorous supportive care is essential to the treatment of pediatric non-Hodgkin lymphomas (NHL). We describe the safety and tolerability of HD-MTX in patients with NHL treated at our center. In our cohort of 46 patients, the majority had at least one course of delayed clearance and/or creatinine elevation. Additionally, more than one-third of patients experienced an episode of grade ≥3 mucositis. Creatinine elevations and delayed clearance were independently associated with subsequent grade ≥3 mucositis. We advocate for greater availability of methotrexate monitoring to allow dose escalation of this essential modality around the world.
摘要
大剂量甲氨蝶呤（HD-MTX）联合严格的支持治疗对儿童非霍奇金淋巴瘤（NHL）的治疗至关重要。我们描述了在我们中心接受治疗的 NHL 患者使用 HD-MTX 的安全性和耐受性。在我们的 46 名患者队列中，大多数患者至少有一次出现清除延迟和/或肌酐升高。此外，超过三分之一的患者发生了≥3 级黏膜炎。肌酐升高和清除延迟与随后的≥3 级黏膜炎独立相关。我们主张在全球范围内提供更多的甲氨蝶呤监测，以允许这种重要治疗方法的剂量升级。
相似文献
1
Safety analysis of high-dose methotrexate in pediatric non-Hodgkin lymphomas.儿童非霍奇金淋巴瘤中甲氨蝶呤大剂量治疗的安全性分析。
Pediatr Blood Cancer. 2022 Nov;69(11):e29940. doi: 10.1002/pbc.29940. Epub 2022 Sep 7.
2
Serum Creatinine Versus Plasma Methotrexate Levels to Predict Toxicities in Children Receiving High-dose Methotrexate.血清肌酐与血浆甲氨蝶呤水平用于预测接受高剂量甲氨蝶呤治疗儿童的毒性反应
Pediatr Hematol Oncol. 2015;32(8):576-84. doi: 10.3109/08880018.2015.1087612. Epub 2015 Nov 11.
3
4
Serum creatinine and creatinine clearance for predicting plasma methotrexate concentrations after high-dose methotrexate chemotherapy for the treatment for childhood lymphoblastic malignancies.血清肌酐和肌酐清除率预测儿童急性淋巴细胞白血病大剂量甲氨蝶呤化疗后血药浓度。
Cancer Chemother Pharmacol. 2014 Jan;73(1):79-86. doi: 10.1007/s00280-013-2319-2. Epub 2013 Oct 25.
5
Pharmacokinetics and pharmacogenetics of high-dose methotrexate in Chinese adult patients with non-Hodgkin lymphoma: a population analysis.中国成人非霍奇金淋巴瘤患者大剂量甲氨蝶呤的药代动力学和药物基因组学：群体分析。
Cancer Chemother Pharmacol. 2020 May;85(5):881-897. doi: 10.1007/s00280-020-04058-4. Epub 2020 Apr 3.
6
7
Ambulatory high-dose methotrexate administration as central nervous system prophylaxis in patients with aggressive lymphoma.大剂量氨甲喋呤间歇性输注作为侵袭性淋巴瘤患者中枢神经系统预防用药。
Ann Hematol. 2021 Apr;100(4):979-986. doi: 10.1007/s00277-020-04341-7. Epub 2021 Feb 19.
8
Improving the safety of high-dose methotrexate for children with hematologic cancers in settings without access to MTX levels using extended hydration and additional leucovorin.采用延长水化和补充亚叶酸的方法，提高无法检测甲氨蝶呤水平的环境中治疗血液系统恶性肿瘤儿童大剂量甲氨蝶呤的安全性。
Pediatr Blood Cancer. 2018 Dec;65(12):e27241. doi: 10.1002/pbc.27241. Epub 2018 May 16.
9
[Therapeutic management of central nervous system lymphomas in a single hematological institute].[单一血液学机构中中枢神经系统淋巴瘤的治疗管理]
Orv Hetil. 2009 Oct 18;150(42):1937-44. doi: 10.1556/OH.2009.28703.
10
Statistical analysis of relation between plasma methotrexate concentration and toxicity in high-dose methotrexate therapy of childhood nonHodgkin lymphoma.儿童非霍奇金淋巴瘤大剂量甲氨蝶呤治疗中血浆甲氨蝶呤浓度与毒性关系的统计分析
Pediatr Blood Cancer. 2015 Feb;62(2):279-284. doi: 10.1002/pbc.25305. Epub 2014 Oct 30.
引用本文的文献
1
Metabolic profiling of patient-derived organoids reveals nucleotide synthesis as a metabolic vulnerability in malignant rhabdoid tumors.患者来源类器官的代谢谱分析揭示核苷酸合成是恶性横纹肌样肿瘤的一种代谢弱点。
Cell Rep Med. 2025 Jan 21;6(1):101878. doi: 10.1016/j.xcrm.2024.101878. Epub 2024 Dec 20.
本文引用的文献
1
Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1.本妥昔单抗维迪昔与化疗联合治疗 ALK+ ALCL 儿科患者：COG 试验 ANHL12P1 的结果。
Blood. 2021 Jul 1;137(26):3595-3603. doi: 10.1182/blood.2020009806.
2
Five decades of low intensity and low survival: adapting intensified regimens to cure pediatric Burkitt lymphoma in Africa.五十年的低强度与低生存率：调整强化治疗方案以治愈非洲儿童伯基特淋巴瘤
Blood Adv. 2020 Aug 25;4(16):4007-4019. doi: 10.1182/bloodadvances.2020002178.
3
Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children.利妥昔单抗治疗高危、成熟 B 细胞非霍奇金淋巴瘤患儿。
N Engl J Med. 2020 Jun 4;382(23):2207-2219. doi: 10.1056/NEJMoa1915315.
4
Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d'Oncologie Pédiatrique.撒哈拉以南非洲儿科病房的晚期伯基特淋巴瘤：法非儿科肿瘤学组第三次前瞻性多中心研究结果
J Glob Oncol. 2019 Nov;5:1-9. doi: 10.1200/JGO.19.00172.
5
Rituximab with chemotherapy in children and adolescents with central nervous system and/or bone marrow-positive Burkitt lymphoma/leukaemia: a Children's Oncology Group Report.利妥昔单抗联合化疗治疗中枢神经系统和/或骨髓阳性的儿童及青少年伯基特淋巴瘤/白血病：儿童肿瘤学组报告
Br J Haematol. 2014 Nov;167(3):394-401. doi: 10.1111/bjh.13040. Epub 2014 Jul 26.
6
Declining childhood and adolescent cancer mortality.儿童和青少年癌症死亡率下降。
Cancer. 2014 Aug 15;120(16):2497-506. doi: 10.1002/cncr.28748. Epub 2014 May 22.
7
Rituximab and FAB/LMB 96 chemotherapy in children with Stage III/IV B-cell non-Hodgkin lymphoma: a Children's Oncology Group report.利妥昔单抗与FAB/LMB 96化疗方案用于Ⅲ/Ⅳ期B细胞非霍奇金淋巴瘤儿童患者：儿童肿瘤学组报告
Leukemia. 2013 Apr;27(5):1174-7. doi: 10.1038/leu.2012.255. Epub 2012 Sep 3.
8
Advanced stage, increased lactate dehydrogenase, and primary site, but not adolescent age (≥ 15 years), are associated with an increased risk of treatment failure in children and adolescents with mature B-cell non-Hodgkin's lymphoma: results of the FAB LMB 96 study.晚期、乳酸脱氢酶升高以及原发部位，但不是青少年年龄（≥15 岁），与成熟 B 细胞非霍奇金淋巴瘤患儿和青少年治疗失败风险增加相关：FAB LMB 96 研究结果。
J Clin Oncol. 2012 Feb 1;30(4):387-93. doi: 10.1200/JCO.2010.33.3369. Epub 2012 Jan 3.
9
Safety assessment of intensive induction therapy in childhood anaplastic large cell lymphoma: report of the ALCL99 randomised trial.儿童间变性大细胞淋巴瘤强化诱导治疗的安全性评估：ALCL99 随机试验报告。
Pediatr Blood Cancer. 2011 Jul 1;56(7):1071-7. doi: 10.1002/pbc.22940. Epub 2011 Jan 28.
10
Excellent survival following two courses of COPAD chemotherapy in children and adolescents with resected localized B-cell non-Hodgkin's lymphoma: results of the FAB/LMB 96 international study.接受两疗程COPAD化疗的儿童和青少年切除性局限性B细胞非霍奇金淋巴瘤患者生存率极佳：FAB/LMB 96国际研究结果
Br J Haematol. 2008 Jun;141(6):840-7. doi: 10.1111/j.1365-2141.2008.07144.x. Epub 2008 Mar 26.
Zotero 插件