Evidence map›Paper›PMID 41111074›Full record

Observational studyJournal of the Egyptian National Cancer Institute2025

Comprehensive evaluation of high dose methotrexate therapy: a retrospective observational trial.

Hadeer Ehab Barakat, Kholood Ashraf El Bahy, Sandy Victor Labib, Yasser Zakaria Aldesouky, Abdelrahman Ayman Ismail, Mohamed El Sayed Mohamed, Febrona Louis Sedky, Asmaa Mohamed Abdelhady, Dalia Hamdy Gaballah, Doha Ashraf Ali and 9 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the Egyptian National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Hadeer Ehab BarakatAhram Canadian University, Giza, Egypt. hadeer.ehab7785@gmail.com.
Kholood Ashraf El BahyAhram Canadian University, Giza, Egypt.
Sandy Victor LabibAhram Canadian University, Giza, Egypt.
Yasser Zakaria AldesoukyAhram Canadian University, Giza, Egypt.
Abdelrahman Ayman IsmailAhram Canadian University, Giza, Egypt.
Mohamed El Sayed MohamedAhram Canadian University, Giza, Egypt.
Febrona Louis SedkyAhram Canadian University, Giza, Egypt.
Asmaa Mohamed AbdelhadyAhram Canadian University, Giza, Egypt.
Dalia Hamdy GaballahAhram Canadian University, Giza, Egypt.
Doha Ashraf AliAhram Canadian University, Giza, Egypt.
Passant Mohamed RefaatAhram Canadian University, Giza, Egypt.
Hasnaa Al Sayed MohamedAhram Canadian University, Giza, Egypt.
Ahmed Zayed MohamedAhram Canadian University, Giza, Egypt.
Salwa Selim IbrahimAhram Canadian University, Giza, Egypt.
Ayman M NoreddinAhram Canadian University, Giza, Egypt.
Abdel-Moneim M OsmanNational cancer institute, cairo University, Giza, Egypt.
Esraa M AbdelkeriemNational cancer institute, cairo University, Giza, Egypt.
Mohamed M Sayed-AhmedNational cancer institute, cairo University, Giza, Egypt.
Riham M KarkeetNational cancer institute, cairo University, Giza, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMethotrexate (MTX) is a commonly prescribed drug with both chemotherapeutic and immunosuppressive applications. However, when administered in high doses (HDMTX ≥ 500 mg/m

methodsA retrospective cohort study was conducted at the National Cancer Institute, Cairo University. Patients receiving HDMTX as part of their cancer treatment in the period from January 2022 to December 2024 were included. Data collection included patient demographics, administered MTX doses, 48-h serum MTX levels, medical and medication history, antimicrobials used, and recorded adverse effects. The outcome of the study encompassed the identification of predictors for 48-h MTX levels and their association with acute kidney injury (AKI), ICU admission, and LOS. In addition to the associations with hepatotoxicity, antimicrobial usage, and mortality. Statistical analysis was performed using SPSS version 26.0.

resultsAmong 143 patients, elevated 48-h MTX levels (≥ 1.28 μmol/L) were associated with pleural effusion (P-value 0.038), patients diagnosed with lymphoma (P-value 0.05), and increased antimicrobial use (P-value < 0.05). A significant association was found between HDMTX and the use of carbapenems, vancomycin and fluoroquinolones (P-value < 0.05). Non-significant relation was found between HDMTX and AKI as well as LOS. Hepatotoxicity was significantly more common in patients with osteosarcoma rather than hematological malignancies, while LOS was shorter in osteosarcoma cases compared to hematological malignancies.

conclusionThe serum levels of 48-h MTX are vital metrics of toxicity, as they determine the duration of hospitalization, the number of antimicrobials used, and the mortality rate. Thus, it is crucial to monitor these levels to reduce the complications associated with HDMTX usage.

Indexed as

Antimetabolites, AntineoplasticChemical and Drug Induced Liver InjuryMethotrexateNeoplasmsAcute Kidney InjuryAdultAgedFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesAntimetabolites, AntineoplasticMethotrexateAcute kidney injuryHepatotoxicityLength of hospital stayMethotrexateMortality

Identifiers

PMID41111074
PMCPMC13313389

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.