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.
Pediatr Blood Cancer. 2022 Nov;69(11):e29940. doi: 10.1002/pbc.29940. Epub 2022 Sep 7.
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.
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。
