Delayed methotrexate clearance in a patient with sickle cell anemia and osteosarcoma

Elpis Mantadakis, Zora R. Rogers, Angela K. Smith, Raymond Quigley, Arleen F. Ratliff, Barton A. Kamen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

A 15-year-old girl with homozygous sickle cell anemia (HbSS) and osteosarcoma is described. Delayed clearance of methotrexate (MTX) after the second course of high-dose MTX (HDMTX) led to the development of renal and hepatic toxicities. Rescue was accomplished with high-dose leucovorin, intravenous carboxypeptidase G2, and thymidine. Although the renal and hepatic abnormalities resolved, focal tonic-clonic seizures developed, accompanied by abnormal brain imaging. Four weeks after this episode, all clinical and biochemical abnormalities resolved. Preexistent end-organ damage associated with HbSS may compromise the ability to deliver high-dose chemotherapy with curative intent in patients with malignant disease.

Original languageEnglish (US)
Pages (from-to)165-169
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume21
Issue number2
DOIs
StatePublished - Mar 1999

Fingerprint

Epilepsy, Partial, Motor
Sickle Cell Anemia
Osteosarcoma
Methotrexate
gamma-Glutamyl Hydrolase
Kidney
Leucovorin
Liver
Neuroimaging
Thymidine
Seizures
Drug Therapy

Keywords

  • Carboxypeptidase G2
  • Hepatotoxicity
  • Leucovorin
  • Methotrexate rescue
  • Neurologic toxicity
  • Osteosarcoma
  • Renal failure
  • Sickle cell anemia
  • Thymidine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Hematology

Cite this

Delayed methotrexate clearance in a patient with sickle cell anemia and osteosarcoma. / Mantadakis, Elpis; Rogers, Zora R.; Smith, Angela K.; Quigley, Raymond; Ratliff, Arleen F.; Kamen, Barton A.

In: Journal of Pediatric Hematology/Oncology, Vol. 21, No. 2, 03.1999, p. 165-169.

Research output: Contribution to journalArticle

Mantadakis, Elpis ; Rogers, Zora R. ; Smith, Angela K. ; Quigley, Raymond ; Ratliff, Arleen F. ; Kamen, Barton A. / Delayed methotrexate clearance in a patient with sickle cell anemia and osteosarcoma. In: Journal of Pediatric Hematology/Oncology. 1999 ; Vol. 21, No. 2. pp. 165-169.
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