Weekly methotrexate-calcium leucovorin rescue: effect of alkalinization on nephrotoxicity; pharmacokinetics in the CNS; and use in CNS non-Hodgkin's lymphoma.

摘要: Urinary alkalinization with oral sodium bicarbonate has decreased the incidence of acute nephrotoxicity and subsequent myelotoxicity in 18 adults receiving high-dose methotrexate calcium leucovorin rescue (MTX-LCV) weekly doses 1-7.5 g/m2. Close monitoring 24-hour serum creatinine MTX levels can predict patients at risk for serious toxicity. By a prompt (24-36 hours) increase LCV dose rate, hematologic biochemical evidence myelosuppression been prevented. Kinetic parameters lumbar cerebrospinal fluid (CSF) were studied two following iv injection 3 7.5 g/m2 respectively. Lumbar CSF concentrations greater than 1 muM are achieved. The half-life (11.95 is twice as long half-life. In presence carcinomatous meningitis, further delay clearance from was seen. With MTX-LCV, there have four objective responses six non-Hodgkin's lymphoma CNS relapse, including complete regression two. It suggested that therapeutic be achieved central nervous system MTX-LCV.