Sistema de Salut de Catalunya
Institut Català de la Salut
[Bielack SS] Paediatrics 5 (Oncology, Haematology, Immunology), Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Centre, Stuttgart, Germany. [Soussain C] Service d’Hématologie, Institut Curie, Paris, France. [Fox CP] School of Medicine, University of Nottingham, Nottingham, UK. [Houillier C] Department of Neurooncology, IHU, ICM, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France. [Murciano T] Servei d’Hematologia i Oncologia Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Osborne W] Department of Haematology, Newcastle Upon Tyne NHS Foundation Trust, and Newcastle University, Newcastle Upon Tyne, UK
Vall d'Hebron Barcelona Hospital Campus
2024-11-25T13:38:42Z
2024-11-25T13:38:42Z
2024-10-02
Consensus; Glucarpidase; Methotrexate toxicity
Consens; Glucarpidasa; Toxicitat del metotrexat
Consenso; Glucarpidasa; Toxicidad del metotrexato
High-dose methotrexate (HDMTX) is used in the treatment of a range of adult and childhood cancers. Although HDMTX can provide effective anti-tumor activity with an acceptable safety profile for most patients, delayed methotrexate elimination (DME) develops in a minority of patients receiving HDMTX and may be accompanied by renal dysfunction and potentially life-threatening toxicity. A panel of European physicians with experience in the use of HDMTX as well as of glucarpidase convened to develop a series of consensus statements to provide practical guidance on the prevention and treatment of DME, including the use of glucarpidase. Robust implementation of supportive measures including hyperhydration and urine alkalinization emerged as critical in order to reduce the risk of DME with HDMTX treatment, with leucovorin rescue critical in reducing the risk of DME complications. Early recognition of DME is important to promptly implement appropriate treatment including, intensified hydration, high-dose leucovorin and, when appropriate, glucarpidase.
Article
Published version
English
Càncer - Tractament; Decisió de grup; Antimetabòlits - Ús terapèutic; DISEASES::Neoplasms; Other subheadings::Other subheadings::Other subheadings::/drug therapy; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Antimetabolites::Antimetabolites, Antineoplastic; Other subheadings::Other subheadings::/therapeutic use; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; ENFERMEDADES::neoplasias; Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::antimetabolitos::antimetabolitos antineoplásicos; Otros calificadores::Otros calificadores::/uso terapéutico; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso
Springer
Journal of Cancer Research and Clinical Oncology;150(10)
https://doi.org/10.1007/s00432-024-05945-6
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
