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[Carboxypeptidase-G2-rescue in a woman with methotrexate-induced renal failure].

AbstractBACKGROUND:
Methotrexate (MTX) is a very effective chemotherapeutic drug, widely used in various malignant diseases for systemic therapy. In some cases, MTX-induced renal failure occurs which may not be prevented by the standard agent folin acid as a specific antidot. This results in a MTX-accumulation in the body tissue with subsequent massive toxic side effects.
CASE REPORT:
We report on a 62-year-old woman with acute lymphoblastic leukemia (first diagnosis November 1997) receiving chemotherapy with 2,340 mg methotrexate over 24 hours. After an increase of the MTX-plasma-level 36 hours following MTX-application, increased serum creatinine levels (maximum 5.07 mg/dl) were found. The application of folinic acid was without any significant effect. Fifty-six hours following MTX, 50 U/kg carboxypeptidase-G2 was infused. The MTX-plasma-level decreased rapidly and a recovery of renal function was monitored.
CONCLUSION:
CPDG2 may be highly effective in patients after development of an MTX-induced renal failure and delayed MTX-excretion.
AuthorsA von Poblozki, W Dempke, H J Schmoll
JournalMedizinische Klinik (Munich, Germany : 1983) (Med Klin (Munich)) Vol. 95 Issue 8 Pg. 457-60 (Aug 15 2000) ISSN: 0723-5003 [Print] Germany
Vernacular TitleCarboxypeptidase-G2-Rescue bei einer Patientin mit Methotrexat-induziertem Nierenversagen.
PMID10985069 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Antimetabolites, Antineoplastic
  • Creatinine
  • gamma-Glutamyl Hydrolase
  • Methotrexate
Topics
  • Acute Kidney Injury (blood, chemically induced, drug therapy)
  • Antimetabolites, Antineoplastic (adverse effects, blood)
  • Creatinine (blood)
  • Female
  • Humans
  • Infusions, Intravenous
  • Methotrexate (adverse effects, blood)
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, drug therapy)
  • Treatment Outcome
  • gamma-Glutamyl Hydrolase (administration & dosage, therapeutic use)

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