Carboxypeptidase G2 rescue in a 79 year-old patient with cranial lymphoma after high-dose methotrexate induced acute renal failure.

Abstract

A 79 year-old female patient presented with immunoblastic B-cell lymphoma of the ethmoidal sinuses and destruction of the anterior cranial fossa. After 3 cycles of high-dose methorexate (HD-MTX) MTX serum level remained elevated and creatinine serum levels raised. The patient received Carboxypeptidase G2 (CPG2) intravenously. Within one hour the MTX serum level decreased to <1 micromol/l as determined by high pressure liquid chromatography (HPLC). The patient recovered without significant toxicity and attained a long lasting ongoing (>14 months) complete remission. In this case we were able to demonstrate that rescue from HD-MT nephrotoxicity by CPG2 is also safe and effective in patients with advanced age with impaired renal function. With the help of CPG2, sufficient and potentially curative therapy with HD-MTX may also be provided to patients with a high risk of renal failure.

• Authors: A Krackhardt, S Schwartz, A Korfel, E Thiel
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 35 Issue 5-6 Pg. 631-5 (Nov 1999) ISSN: 1042-8194 [Print] United States
• PMID: 10609804 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Bacterial Proteins
• Diuretics
• Procarbazine
• Vincristine
• Furosemide
• Dexamethasone
• Doxorubicin
• Cyclophosphamide
• Folic Acid
• gamma-Glutamyl Hydrolase
• Leucovorin
• Carmustine
• Prednisone
• Methotrexate

Topics

• Acute Kidney Injury (chemically induced, drug therapy, therapy)
• Aged
• Antimetabolites, Antineoplastic (administration & dosage, adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bacterial Proteins (therapeutic use)
• Carmustine (administration & dosage)
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Dexamethasone (administration & dosage)
• Diuretics (therapeutic use)
• Doxorubicin (administration & dosage)
• Ethmoid Sinus
• Female
• Fluid Therapy
• Folic Acid (metabolism)
• Furosemide (therapeutic use)
• Humans
• Leucovorin (administration & dosage)
• Lymphoma, B-Cell (drug therapy)
• Lymphoma, Large-Cell, Immunoblastic (drug therapy, pathology)
• Methotrexate (administration & dosage, adverse effects, antagonists & inhibitors, metabolism)
• Paranasal Sinus Neoplasms (drug therapy)
• Prednisone (administration & dosage)
• Procarbazine (administration & dosage)
• Remission Induction
• Vincristine (administration & dosage)
• gamma-Glutamyl Hydrolase (therapeutic use)