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 |
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タイトル |
Early Recognition of Patients with Decreased Methotrexate Clearance Following High-Dose Methotrexate Infusion Therapy |
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言語 |
en |
作成者 |
Ikeda, Hiroaki
Kihira, Kenji
Kuwata, Naoharu
Arai, Shigeaki
Kimura, Yasuhiro
Miyake, Katsushi
Kitaura, Teruaki
Fujimura, Kingo
Kuramoto, Atsushi
Fukuchi, Hiroshi
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アクセス権 |
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アクセス権 |
open access |
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アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
主題 |
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主題Scheme |
Other |
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主題 |
High-dose methotrexate infusion |
主題 |
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主題Scheme |
Other |
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主題 |
Decreased clearance |
主題 |
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主題Scheme |
Other |
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主題 |
Criterion |
主題 |
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主題Scheme |
Other |
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主題 |
Drug monitoring |
主題 |
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主題Scheme |
Other |
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主題 |
Renal function |
主題 |
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主題Scheme |
NDC |
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主題 |
490 |
内容記述 |
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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. |
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言語 |
en |
出版者 |
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出版者 |
Hiroshima University Medical Press |
言語 |
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言語 |
eng |
資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
departmental bulletin paper |
出版タイプ |
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出版タイプ |
VoR |
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出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
収録物識別子 |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
0018-2052 |
収録物識別子 |
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収録物識別子タイプ |
NCID |
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収録物識別子 |
AA00664312 |
開始ページ |
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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
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旧ID |
37841 |