Clinical observation of mucosal injury after high-dose methotrexate chemotherapy in children with acute lymphoblastic leukemia / 白血病·淋巴瘤

ABSTRACT

Objective:To investigate mucosal injury after high-dose methotrexate (HD-MTX) chemotherapy in treatment of children with acute lymphoblastic leukemia (ALL), and to analyze the association with methotrexate blood concentration, risk stratification and clinical efficacy.Methods:The data of 95 children with ALL who received 539 times of HD-MTX chemotherapy in the First Hospital of Harbin from November 2015 to October 2018 were retrospectively analyzed, and the association of mucosal injury with methotrexate blood concentration, disease risk degree and clinical efficacy was also analyzed.Results:Among 95 children who received 539 times of HD-MTX chemotherapy, the total incidence of mucosal injury was 8.4% (45/539); the incidence of mucosal injury was 4.6% (11/239), 7.6% (8/105), 13.3% (26/195), respectively in the low-risk group, middle-risk group and high-risk group. With the elevation of disease risk, the incidence of mucosal injury was increased ( χ2 = 10.787, P < 0.05). There was no correlation of the degree of mucosal injury with methotrexate blood concentration and disease risk degree (all P > 0.05), and the mucosal injury was not related with the clinical efficacy ( P > 0.05). Conclusion:After the application of HD-MTX in children with ALL, adjustment of the dose of rescue drug by monitoring of methotrexate blood concentration can improve the safety of therapeutic drugs.