Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study

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Standard

Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia : A Danish population-based study. / Schmidt, Diana; Kristensen, Kim; Schrøder, Henrik; Wehner, Peder Skov; Rosthøj, Steen; Heldrup, Jesper; Damsgaard, Linn; Schmiegelow, Kjeld; Mikkelsen, Torben Stamm.

I: Pediatric Blood & Cancer, Bind 66, Nr. 6, e27637, 2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Schmidt, D, Kristensen, K, Schrøder, H, Wehner, PS, Rosthøj, S, Heldrup, J, Damsgaard, L, Schmiegelow, K & Mikkelsen, TS 2019, 'Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study', Pediatric Blood & Cancer, bind 66, nr. 6, e27637. https://doi.org/10.1002/pbc.27637

APA

Schmidt, D., Kristensen, K., Schrøder, H., Wehner, P. S., Rosthøj, S., Heldrup, J., ... Mikkelsen, T. S. (2019). Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study. Pediatric Blood & Cancer, 66(6), [e27637]. https://doi.org/10.1002/pbc.27637

Vancouver

Schmidt D, Kristensen K, Schrøder H, Wehner PS, Rosthøj S, Heldrup J o.a. Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study. Pediatric Blood & Cancer. 2019;66(6). e27637. https://doi.org/10.1002/pbc.27637

Author

Schmidt, Diana ; Kristensen, Kim ; Schrøder, Henrik ; Wehner, Peder Skov ; Rosthøj, Steen ; Heldrup, Jesper ; Damsgaard, Linn ; Schmiegelow, Kjeld ; Mikkelsen, Torben Stamm. / Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia : A Danish population-based study. I: Pediatric Blood & Cancer. 2019 ; Bind 66, Nr. 6.

Bibtex

@article{7883963e0f734ef3b942c4a1734317ad,
title = "Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study",
abstract = "Background: Severely delayed elimination of methotrexate (MTX) is difficult to predict in patients treated with high-dose MTX (HD-MTX), but it may cause life-threatening toxicity. It has not been defined how an increase in plasma creatinine can be best used as a predictor for severely delayed MTX elimination, thus providing a guide for therapeutic interventions to minimize renal toxicity.Methods: Pharmacokinetic data were retrospectively collected on 218 Danish children with acute lymphoblastic leukemia treated with HD-MTX 5 or 8 g/m2 on the NOPHO2000 protocol. Moderately delayed MTX elimination was defined as 42-hour plasma MTX ≥ 4.0-9.9 μM, and severely delayed elimination was defined as 42-hour plasma MTX ≥ 10 μM.Results: Median 42-hour plasma MTX was 0.61 μM (interquartile range, 0.4-1.06 μM). Of 1295 MTX infusions with 5 g/m2 (n = 140 patients) or 8 g/m2 (n = 78 patients), 5.1{\%} were severely (1.5{\%}) or moderately (3.6{\%}) delayed. The risk of having delayed elimination was highest in the first of eight infusions with MTX 5 g/m² (7.4{\%} vs 0.0 to 4.1{\%} for subsequent MTX infusions) (P < 0.02). A 25 μM increase or a 1.5-fold increase in plasma creatinine within 36 hours from start of the MTX infusion had a sensitivity of 92{\%} (95{\%} CI, 82{\%}-97{\%}) and a specificity of 85{\%} (95{\%} CI, 83{\%}-87{\%}) for predicting 42-hour MTX ≥4.0 μM.Conclusions: A 25 μM increase or a 1.5-fold in plasma creatinine within 36 hours after start of an HD-MTX infusion can predict delayed MTX elimination, thus allowing intensification of hydration and alkalization to avoid further renal toxicity and promote the elimination of MTX.",
keywords = "Faculty of Science, Acute leukemias, ALL, Chemotherapy, Methotrexate, Support care cancer pharmacology",
author = "Diana Schmidt and Kim Kristensen and Henrik Schr{\o}der and Wehner, {Peder Skov} and Steen Rosth{\o}j and Jesper Heldrup and Linn Damsgaard and Kjeld Schmiegelow and Mikkelsen, {Torben Stamm}",
note = "(ekstern) {\circledC} 2019 Wiley Periodicals, Inc.",
year = "2019",
doi = "10.1002/pbc.27637",
language = "English",
volume = "66",
journal = "Pediatric Blood & Cancer",
issn = "1545-5009",
publisher = "JohnWiley & Sons, Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia

T2 - A Danish population-based study

AU - Schmidt, Diana

AU - Kristensen, Kim

AU - Schrøder, Henrik

AU - Wehner, Peder Skov

AU - Rosthøj, Steen

AU - Heldrup, Jesper

AU - Damsgaard, Linn

AU - Schmiegelow, Kjeld

AU - Mikkelsen, Torben Stamm

N1 - (ekstern) © 2019 Wiley Periodicals, Inc.

PY - 2019

Y1 - 2019

N2 - Background: Severely delayed elimination of methotrexate (MTX) is difficult to predict in patients treated with high-dose MTX (HD-MTX), but it may cause life-threatening toxicity. It has not been defined how an increase in plasma creatinine can be best used as a predictor for severely delayed MTX elimination, thus providing a guide for therapeutic interventions to minimize renal toxicity.Methods: Pharmacokinetic data were retrospectively collected on 218 Danish children with acute lymphoblastic leukemia treated with HD-MTX 5 or 8 g/m2 on the NOPHO2000 protocol. Moderately delayed MTX elimination was defined as 42-hour plasma MTX ≥ 4.0-9.9 μM, and severely delayed elimination was defined as 42-hour plasma MTX ≥ 10 μM.Results: Median 42-hour plasma MTX was 0.61 μM (interquartile range, 0.4-1.06 μM). Of 1295 MTX infusions with 5 g/m2 (n = 140 patients) or 8 g/m2 (n = 78 patients), 5.1% were severely (1.5%) or moderately (3.6%) delayed. The risk of having delayed elimination was highest in the first of eight infusions with MTX 5 g/m² (7.4% vs 0.0 to 4.1% for subsequent MTX infusions) (P < 0.02). A 25 μM increase or a 1.5-fold increase in plasma creatinine within 36 hours from start of the MTX infusion had a sensitivity of 92% (95% CI, 82%-97%) and a specificity of 85% (95% CI, 83%-87%) for predicting 42-hour MTX ≥4.0 μM.Conclusions: A 25 μM increase or a 1.5-fold in plasma creatinine within 36 hours after start of an HD-MTX infusion can predict delayed MTX elimination, thus allowing intensification of hydration and alkalization to avoid further renal toxicity and promote the elimination of MTX.

AB - Background: Severely delayed elimination of methotrexate (MTX) is difficult to predict in patients treated with high-dose MTX (HD-MTX), but it may cause life-threatening toxicity. It has not been defined how an increase in plasma creatinine can be best used as a predictor for severely delayed MTX elimination, thus providing a guide for therapeutic interventions to minimize renal toxicity.Methods: Pharmacokinetic data were retrospectively collected on 218 Danish children with acute lymphoblastic leukemia treated with HD-MTX 5 or 8 g/m2 on the NOPHO2000 protocol. Moderately delayed MTX elimination was defined as 42-hour plasma MTX ≥ 4.0-9.9 μM, and severely delayed elimination was defined as 42-hour plasma MTX ≥ 10 μM.Results: Median 42-hour plasma MTX was 0.61 μM (interquartile range, 0.4-1.06 μM). Of 1295 MTX infusions with 5 g/m2 (n = 140 patients) or 8 g/m2 (n = 78 patients), 5.1% were severely (1.5%) or moderately (3.6%) delayed. The risk of having delayed elimination was highest in the first of eight infusions with MTX 5 g/m² (7.4% vs 0.0 to 4.1% for subsequent MTX infusions) (P < 0.02). A 25 μM increase or a 1.5-fold increase in plasma creatinine within 36 hours from start of the MTX infusion had a sensitivity of 92% (95% CI, 82%-97%) and a specificity of 85% (95% CI, 83%-87%) for predicting 42-hour MTX ≥4.0 μM.Conclusions: A 25 μM increase or a 1.5-fold in plasma creatinine within 36 hours after start of an HD-MTX infusion can predict delayed MTX elimination, thus allowing intensification of hydration and alkalization to avoid further renal toxicity and promote the elimination of MTX.

KW - Faculty of Science

KW - Acute leukemias

KW - ALL

KW - Chemotherapy

KW - Methotrexate

KW - Support care cancer pharmacology

U2 - 10.1002/pbc.27637

DO - 10.1002/pbc.27637

M3 - Journal article

C2 - 30835935

VL - 66

JO - Pediatric Blood & Cancer

JF - Pediatric Blood & Cancer

SN - 1545-5009

IS - 6

M1 - e27637

ER -

ID: 216862929