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  1. 広島大学の刊行物
  2. Hiroshima Journal of Medical Sciences
  3. 45巻2号

Early Recognition of Patients with Decreased Methotrexate Clearance Following High-Dose Methotrexate Infusion Therapy

https://hiroshima.repo.nii.ac.jp/records/2013391
https://hiroshima.repo.nii.ac.jp/records/2013391
824209bf-cb13-40fc-8b49-a004d125316a
名前 / ファイル ライセンス アクション
HiroshimaJMedSci_45_57.pdf HiroshimaJMedSci_45_57.pdf (526.0 KB)
Item type デフォルトアイテムタイプ_(フル)(1)
公開日 2023-03-18
タイトル
タイトル Early Recognition of Patients with Decreased Methotrexate Clearance Following High-Dose Methotrexate Infusion Therapy
言語 en
作成者 Ikeda, Hiroaki

× Ikeda, Hiroaki

en Ikeda, Hiroaki

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Kihira, Kenji

× Kihira, Kenji

en Kihira, Kenji

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Kuwata, Naoharu

× Kuwata, Naoharu

en Kuwata, Naoharu

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Arai, Shigeaki

× Arai, Shigeaki

en Arai, Shigeaki

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Kimura, Yasuhiro

× Kimura, Yasuhiro

en Kimura, Yasuhiro

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Miyake, Katsushi

× Miyake, Katsushi

en Miyake, Katsushi

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Kitaura, Teruaki

× Kitaura, Teruaki

en Kitaura, Teruaki

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Fujimura, Kingo

× Fujimura, Kingo

en Fujimura, Kingo

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Kuramoto, Atsushi

× Kuramoto, Atsushi

en Kuramoto, Atsushi

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Fukuchi, Hiroshi

× Fukuchi, Hiroshi

en Fukuchi, Hiroshi

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アクセス権
アクセス権 open access
アクセス権URI http://purl.org/coar/access_right/c_abf2
主題
主題Scheme Other
主題 High-dose methotrexate infusion
主題
主題Scheme Other
主題 Decreased clearance
主題
主題Scheme Other
主題 Criterion
主題
主題Scheme Other
主題 Drug monitoring
主題
主題Scheme Other
主題 Renal function
主題
主題Scheme NDC
主題 490
内容記述
内容記述 The purpose of this study was to identify the patients with decreased methotrexate (MTX) clearance as early as possible after the start of high-dose methotrexate (HD-MTX) infusion. Fifty-six patients (age: 18~83 years) received a HD-MTX infusion (dosage: 1.9~3.8 g/m2) for 6 h. These patients were retrospectively divided into a low-clearance group and a high-clearance group based on the serum MTX concentration at 48 h (1 μM). Six out of the 56 patients showed decreased MTX clearance. The MTX concentrations in the low-clearance group were significantly higher than those in the high-clearance group even in earlier sampling times than at 48 h. The average MTX concentrations were 330 μM at 6 h, 72 μM at 12 h, and 16 μM at 24 h in the low-clearance group, and those in the high-clearance group were 210 μM, 18 μM, and 1.0 μM, respectively. The estimated elimination half-lives (t1/2) at 6~12 h and 12 ~ 24 h after the start of the infusion were also significantly longer in the low-clearance group (2.8 vs. 1.7 h and 5.0 vs. 2.8 h, respectively). Therefore, we proposed convenient criteria based on the mean + 1 S.D. of the high-clearance group: the concentration > 270 μM at 6 h and > 32 μM at 12 h; the t1/2 value > 2.1 h at 6~12 h. All 6 patients were recognized as belonging to the low-clearance group at an early stage after HD-MTX infusion by using our proposed criteria. These results indicate that patients with decreased MTX clearance could be identified within the first 12 h after the start of HD-MTX infusion. The factors influencing the prolonged elimination of MTX were also investigated. A significant decrease in renal function on day 2 was observed in the low-clearance group. The MTX level at 12 h and the estimated t1/2 values were significantly correlated with BUN, Ser and Clcr on the 2nd day after HD-MTX therapy, suggesting that an alteration in renal function occurs within 12 h of the HD-MTX infusion. The prolonged elimination of MTX could be attributable to this decrease in renal function.
言語 en
出版者
出版者 Hiroshima University Medical Press
言語
言語 eng
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ departmental bulletin paper
出版タイプ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
収録物識別子
収録物識別子タイプ ISSN
収録物識別子 0018-2052
収録物識別子
収録物識別子タイプ NCID
収録物識別子 AA00664312
開始ページ
開始ページ 57
書誌情報 Hiroshima Journal of Medical Sciences
Hiroshima Journal of Medical Sciences

巻 45, 号 2, p. 57-62, 発行日 1996-06
旧ID 37841
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