TY - JOUR
T1 - High incidence of methotrexate associated renal toxicity in patients with lymphoma
T2 - A retrospective analysis
AU - May, Jori
AU - Carson, Kenneth R.
AU - Butler, Sara
AU - Liu, Weijian
AU - Bartlett, Nancy L.
AU - Wagner-Johnston, Nina D.
PY - 2014/6
Y1 - 2014/6
N2 - High-dose methotrexate (HDMTX), defined by doses of methotrexate (MTX) ≥ 1 g/m2, is a widely used regimen known to cause renal toxicity. The reported incidence of renal toxicity in patients with osteosarcoma is 1.8%, but the incidence in hematologic malignancies is not well characterized. In this retrospective study of 649 cycles of HDMTX in 194 patients, renal toxicity occurred in 9.1% of cycles in patients with lymphoma compared to 1.5% in patients with sarcoma. Older age, male sex, decreased baseline creatinine clearance (CrCl) and increased proton pump inhibitor use among the lymphoma population likely contributed to the observed difference. The incidence of renal toxicity was independent of the incidence of delayed MTX elimination, suggesting that kidney function is only one factor involved in MTX clearance. Renal toxicity prolonged the duration of hospitalization but severe renal insufficiency was uncommon. No significant impact on progression-free or overall survival was observed.
AB - High-dose methotrexate (HDMTX), defined by doses of methotrexate (MTX) ≥ 1 g/m2, is a widely used regimen known to cause renal toxicity. The reported incidence of renal toxicity in patients with osteosarcoma is 1.8%, but the incidence in hematologic malignancies is not well characterized. In this retrospective study of 649 cycles of HDMTX in 194 patients, renal toxicity occurred in 9.1% of cycles in patients with lymphoma compared to 1.5% in patients with sarcoma. Older age, male sex, decreased baseline creatinine clearance (CrCl) and increased proton pump inhibitor use among the lymphoma population likely contributed to the observed difference. The incidence of renal toxicity was independent of the incidence of delayed MTX elimination, suggesting that kidney function is only one factor involved in MTX clearance. Renal toxicity prolonged the duration of hospitalization but severe renal insufficiency was uncommon. No significant impact on progression-free or overall survival was observed.
KW - High-dose methotrexate
KW - Lymphoma
KW - Renal toxicity
UR - http://www.scopus.com/inward/record.url?scp=84901296659&partnerID=8YFLogxK
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U2 - 10.3109/10428194.2013.840780
DO - 10.3109/10428194.2013.840780
M3 - Article
C2 - 24004183
AN - SCOPUS:84901296659
SN - 1042-8194
VL - 55
SP - 1345
EP - 1349
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 6
ER -