ReviewJournal of cancer research and clinical oncology2024
A European consensus recommendation on the management of delayed methotrexate elimination: supportive measures, leucovorin rescue and glucarpidase treatment.
Review in Journal of cancer research and clinical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Population pharmacokinetic model of high-dose methotrexate in Malaysian adults with hematological malignancies.European journal of clinical pharmacology · 2026Article
- Methotrexate-Cyclodextrin Systems: Molecular Recognition, Formulation Design, and Translational Perspectives.Current issues in molecular biology · 2026Review
- Toxicity-Tailored Thresholds of Delayed Methotrexate Elimination in Non-Hodgkin Lymphoma: A Population-Based Approach to Therapy Optimization.European journal of drug metabolism and pharmacokinetics · 2026Article
- Glucarpidase efficacy in mitigating methotrexate toxicity is unaffected by concurrent administration of folinic acid.Cancer chemotherapy and pharmacology · 2026Article
- Article
- Novel LC-MS/MS method for measuring methotrexate in high-dose therapy: a comparative study with commercial EMIT and EIA immunoassays.Pharmacological reports : PR · 2026Article
- Induction chemotherapy with methotrexate, nimustine, and procarbazine for primary CNS lymphoma in the elderly: a retrospective evaluation of safety and efficacy.Journal of neuro-oncology · 2026Article
- Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance.Military Medical Research · 2026Review
- High-Dose Methotrexate at All Ages: Safety, Efficacy, and Outcomes from the HDMTX European Registry.Cancers · 2025Article
- The relationship between urine output and time to methotrexate clearance in pediatric leukemia patients receiving high-dose methotrexate therapy.BMC cancer · 2025Article
- Prevention and Treatment of Acute Kidney Injury Associated with High-Dose Methotrexate.Kidney360 · 2025Review
- Consensus on managing delayed methotrexate elimination in high-dose therapy: insights from the Middle East.Frontiers in oncology · 2025Review
- Prodrug-carboxypeptidase G2 therapy: certain concerns on carboxypeptidase G2.Frontiers in pharmacology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
High-dose methotrexate (HDMTX) is used in the treatment of a range of adult and childhood cancers. Although HDMTX can provide effective anti-tumor activity with an acceptable safety profile for most patients, delayed methotrexate elimination (DME) develops in a minority of patients receiving HDMTX and may be accompanied by renal dysfunction and potentially life-threatening toxicity. A panel of European physicians with experience in the use of HDMTX as well as of glucarpidase convened to develop a series of consensus statements to provide practical guidance on the prevention and treatment of DME, including the use of glucarpidase. Robust implementation of supportive measures including hyperhydration and urine alkalinization emerged as critical in order to reduce the risk of DME with HDMTX treatment, with leucovorin rescue critical in reducing the risk of DME complications. Early recognition of DME is important to promptly implement appropriate treatment including, intensified hydration, high-dose leucovorin and, when appropriate, glucarpidase.
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