Zoubek A, Zaunschirm H A, Lion T, Fischmeister G, Vollnhofer G, Gadner H, Pillwein K, Schalhorn A, Bode U
St. Anna Children's Hospital, Vienna, Austria.
Pediatr Hematol Oncol. 1995 Sep-Oct;12(5):471-7. doi: 10.3109/08880019509009477.
We report on an 18.5-year-old woman with osteosarcoma and delayed methotrexate (MTX) elimination due to renal failure after high-dose MTX, in whom rescue with high doses of folinic acid caused intolerable side effects. In this life-threatening clinical situation, the patients was rescued by the administration of recombinant carboxypeptidase G2, a bacterial enzyme that rapidly hydrolyzes MTX into inactive metabolites. This is the first report on the successful clinical use of this alternative catabolic route for the elimination of MTX.
我们报告了一名18.5岁患骨肉瘤的女性患者，其在接受高剂量甲氨蝶呤（MTX）治疗后因肾衰竭导致MTX清除延迟，而高剂量亚叶酸钙解救治疗引起了难以耐受的副作用。在这种危及生命的临床情况下，通过给予重组羧肽酶G2（一种可将MTX迅速水解为无活性代谢产物的细菌酶）对患者进行了救治。这是关于这种用于清除MTX的替代分解代谢途径成功临床应用的首例报告。
