engleski

Methotrexate intoxication during preoperative therapy in children with osteosarcoma

Objective. Evaluation of toxic episodes in children who were treated with HD Methotrexate(8-12g/m2) along with supportive therapy in this cases. Patients. Among 1993-2002 we have treated 46 pts (26 boys, 20 girls) diagnosed with osteosarcoma. They had received high dose of Methotrexate with Leucovorin during preoperative therapy. Results. In our group of patients, 30 had some degree of mucositis, 24 had mild elevation od hepatic enzyms and 3 of them had high elevation of hepatic enzyms, 3 patients with high elevated hepatic enzymes had exanthema, mucositis, oliguria and high value of serum methotrexate. One patient had hypertension. Non of our patients had to have hemodialiysis. 7 patients had positive Candida spp. in mouth or stool and 2 patients had positive hemoculture. As supportive therapy they have received adequate hidration, urine alkalisation, fursemide, djustment of leucovorine dose and nifedipin (boy with hypertension). Mouth and skin hygiene has been taken care of with special attenstion as well as the adequate food preparation. Conclusion. methotrexate intoxiation is treatable revesible complication during preoperative chemotherapy in children with osteosarcoma.

Methotrexate; osteosarcoma

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