High-dose methotrexate treatment for malignant tumors of the hematologic system:analysis of risk factors for delayed excretion
Objective This study aims to explore the occurrence of delayed excretion and its related influencing factors in patients with acute lymphoblastic leukemia(ALL)and non-Hodgkin lymphoma(NHL)receiving high-dose methotrexate(HD-MTX)chemotherapy,in order to provide clinical reference for individualized dosing.Methods Complete chemotherapy data of patients with ALL and NHL who were treated at Xiangya Hospital of Central South University from February 2023 to July 2023 were collected.SPSS 25.0 software was used to analyze the occurrence of delayed excretion and its influencing factors during treatment in patients receiving HD-MTX chemotherapy.Results In all patients included in the study,the overall incidence of delayed excretion during chemotherapy was 30.9%.The incidence rates were 29.7%for pediatric ALL,54.2%for adult ALL,and 24.6%for NHL.When compared with patients in the normal excretion group,there were significant differences in the occurrence of adverse reactions in both the pediatric ALL and NHL groups(P＜0.01);in the adult ALL and NHL groups,there were significant differences in pre-chemotherapy creatinine(Cr)levels(P＜0.05).Two types of drugs in the pediatric ALL and NHL groups respectively showed significant differences:gastric mucosal protective drugs(P = 0.035)and cardiac protective drugs(P = 0.013).Logistic regression analysis results indicated that adverse reactions were independent risk factors for the occurrence of delayed excretion in both pediatric ALL(OR= 6.454,P = 0.007)and NHL(OR=9.751,P = 0.001)groups.In the pediatric group,the T-type disease subtype was identified as an independent risk factor for delayed excretion(OR=3.989,P=0.039).Conclusion Pre-chemotherapy creatinine(Cr)levels may be associated with delayed excretion,and the occurrence of adverse reactions,as well as T-cell type ALL in pediatric patients,are also risk factors for delayed excretion.
High dose methotrexateDelayed excretionAcute lymphoblastic leukemiaNon-Hodgkin lymphoma
万方数据
维普
