Delayed Methotrexate Clearance Despite Carboxypeptidase-G2 (Glucarpidase) Administration in 2 Patients with Toxic Methotrexate Levels

Kirk D. Wyatt, Jeffrey Cooper, Katherine Scott, Eileen Broomall, Sadaf Altaf, Marie C Hogan, Vilmarie Rodriguez, Shakila Khan

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

High-dose methotrexate has been a treatment for osteosarcoma; however, its nephrotoxic effects are considerable. Carboxypeptidase-G2 (glucarpidase) was approved by the US Food and Drug Administration in 2012 for treatment of toxic methotrexate levels. We report our experience using glucarpidase under compassionate use before Food and Drug Administration approval in 2 patients who had delayed methotrexate clearance and prolonged kidney injury despite glucarpidase administration. Our results show that patients with methotrexate toxicity may require repeated doses of glucarpidase in addition to supportive measures, such as dialysis.

Original languageEnglish (US)
Pages (from-to)152-155
Number of pages4
JournalJournal of Pediatric Hematology/Oncology
Volume40
Issue number2
DOIs
StatePublished - Jan 1 2018

Keywords

  • carboxypeptidase G2
  • glucarpidase
  • methotrexate
  • osteosarcoma
  • toxicity

ASJC Scopus subject areas

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

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