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The aim is to assess the safety of re-exposing pediatric patients to high-dose methotrexate after experiencing delayed methotrexate elimination.

Successful re-exposure to high-dose methotrexate after severely delayed methotrexate elimination and renal toxicity in children with acute lymphoblastic leukemia

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The aim is to assess the safety of re-exposing pediatric patients to high-dose methotrexate after experiencing delayed methotrexate elimination.
Evaluated case-level data from 189 patients with ALL who had delayed methotrexate elimination.
Collected information through structured questionnaires from national investigators across 12 countries.
Analyzed clinical and laboratory toxicities after initial delayed elimination and during subsequent re-exposure.
After re-exposure, toxicities were similar to those experienced during the initial delay, being self-limited and non-fatal.
14% of children developed recurrent delayed methotrexate elimination after re-exposure.
Recurrent delayed elimination could not be predicted by various clinical, pharmacokinetic, or demographic factors.

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Evaluates the safety of re-exposure to high-dose methotrexate in children after delayed elimination and renal toxicity, highlighting its feasibility.

Bomken et al. (2026) studied this question.

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Evaluates the safety of re-exposure to high-dose methotrexate in children after delayed elimination and renal toxicity, highlighting its feasibility.