Use of plasma exchange in methotrexate removal in a patient with osteosarcoma and acute renal insufficiency

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dc.contributor.authorCecyn, Karin Zattar [UNIFESP]
dc.contributor.authorOguro, Tsutomo [UNIFESP]
dc.contributor.authorPetrilli, Antonio Sergio [UNIFESP]
dc.contributor.authorBordin, Jose Orlando [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionGRAAC
dc.date.accessioned2016-01-24T12:33:43Z
dc.date.available2016-01-24T12:33:43Z
dc.date.issued2003-03-01
dc.description.abstractAcute renal failure induced by methotrexate (MTX) can be lethal because renal excretion of the drug can be delayed. Pre-existing renal impairment, abstention, or underdosage of folinic acid and inadequate hydration facilitate toxicity. the prolonged high serum levels of MTX result in severe mucositis and pancytopenia, but strategies useful to accelerate MTX removal have not been universally accepted. We report a case of a 13-year-old girl with osteosarcoma who was treated with high-dose MTX because of thoracic tumor recurrence. No side effects were observed after 2 cycles of high-dose MTX; however, after the third cycle there was a delayed MTX elimination followed by clinical toxicity. Forty hours post-MTX infusion the serum level of MTX was 5.39 x 10(-4) mol/L. Treatment was based on symptomatic measures, such as maintenance of an abundant and alkaline diuresis and parenteral administration of folinic acid. Concomitantly, plasma exchange was employed to accelerate MTX removal and reduce its toxicity. After 24 days, she was discharged from the hospital, and her renal function recovered gradually. (C) 2003 Wiley-Liss, Inc.en
dc.description.affiliationUniversidade Federal de São Paulo, Hematol & Transfus Med Serv, Escola Paulista Med, BR-04024002 São Paulo, Brazil
dc.description.affiliationGRAAC, IOP, Pediat Oncol Inst, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Hematol & Transfus Med Serv, Escola Paulista Med, BR-04024002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent209-211
dc.identifierhttp://dx.doi.org/10.1002/ajh.10271
dc.identifier.citationAmerican Journal of Hematology. New York: Wiley-liss, v. 72, n. 3, p. 209-211, 2003.
dc.identifier.doi10.1002/ajh.10271
dc.identifier.issn0361-8609
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27152
dc.identifier.wosWOS:000181292800010
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofAmerican Journal of Hematology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.subjectmethotrexateen
dc.subjectplasma exchangeen
dc.subjectrenal insufficiencyen
dc.titleUse of plasma exchange in methotrexate removal in a patient with osteosarcoma and acute renal insufficiencyen
dc.typeinfo:eu-repo/semantics/article
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