Blood Concentration Monitoring of Methotrexate Chemotherapy in the Treatment of Children with Acute Lymphoblastic Leukemia / 中国药房

ABSTRACT

OBJECTIVE:To improve the efficacy and safety of high dose methotrexate (HDMTX)chemotherapy in the treatment of children with acute lymphoblastic leukemia through blood concentration monitoring.METHODS:27 children with acute lymphoblastic leukemia who received high dose of HDMTX (1.5～4.0 g/m2)for 55 times were involved in this study,the blood samples were collected timely and the blood concentration of methotrexate was determined,the efficacy of the chemotherapy was evaluated according to blood MTX concentration at the ending of its intravenous drip (12h),the calcium folinate relief scheme was determined from the MTX serum concentration in terminal elimination phase.RESULTS: The times for 2.0 g/m2,3.0 g/m2 and 4.0 g/m2 different dosage of methotrexate groups with blood concentration maintained above osmotic concentration(2?10-5mol/L)at the end of intravenous drip (12h)were respectively 75%,92.1%and 100%of the total chemotherapy times.Only one patient was observed with large area of impairment of skin and mucosa,and no severe irreversible adverse reaction were observed in the other cases.CONCLUSIONS: MTX serum concentration monitoring is helpful for mastering the rational rescue dosage of MTX and calcium folinate so as to ensure the efficacy and safety of the chemotherapy.