Info
definition of HD-MTX containing regimen
- High-dose MTX (HDMTX) refers to doses ≥500 mg/m2.
- HDMTX is used for CNS prophylaxis in leukemia and high-risk lymphoma, leptomeningeal metastases, primary CNS lymphoma, and osteosarcoma.
- These regimens involve a 4 to 36-hour infusion of a lethal dose of MTX.
- Leucovorin “rescue” is necessary to terminate the toxic effect of MTX.
- Successful rescue depends on rapid elimination of MTX by the kidneys, requiring aggressive pretreatment, posttreatment hydration, and urinary alkalinization.
- The main toxicities of HDMTX are elevated serum transaminase levels and renal insufficiency, which can affect drug clearance.