What question did this study set out to answer?

To evaluate the incidence of delayed methotrexate elimination and acute kidney injury, alongside their clinical consequences, in patients treated with high-dose methotrexate.

December 30, 2025CancersOpen Access

High-Dose Methotrexate at All Ages: Safety, Efficacy, and Outcomes from the HDMTX European Registry

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Authors

BPBertrand PourroySociété Francophone du Diabète MAM.D. AumenteHospital Universitario Reina Sofía CKChristian KoeneckeLeibniz University Hannover

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Implication

Registry study reveals frequent delayed clearance and kidney injury across cancer patients receiving high-dose methotrexate, highlighting the necessity of diligent monitoring to prevent toxicity.

Key Points

To evaluate the incidence of delayed methotrexate elimination and acute kidney injury, alongside their clinical consequences, in patients treated with high-dose methotrexate.
Analyzed medical records data from 12 institutions in 5 European countries participating in the HDMTX European Registry.
Evaluated 2,501 high-dose methotrexate courses across patients with acute lymphoblastic leukemia, primary CNS lymphoma, non-Hodgkin lymphoma, osteosarcoma, and other CNS cancers.
Assessed primary endpoints of delayed methotrexate elimination (DME) and acute kidney injury (AKI), as well as clinical endpoints using Chi-square and Wilcoxon rank-sum tests.
Across 2,501 total courses, DME occurred in 12.1% (n=302) and AKI occurred in 15.4% (n=384).
DME incidence was highest in primary CNS lymphoma (18.2%) and non-Hodgkin lymphoma (17.2%), while AKI incidence peaked in acute lymphoblastic leukemia courses (21.0%).
Development of DME was significantly associated with extended hospital length of stay, longer delays before subsequent therapy, and more frequent dose reductions and omissions.

Cite This Study

Pourroy et al. (2025) studied this question.

synapsesocial.com/papers/6a7cd2d01df4149ae11d3946 https://doi.org/10.3390/cancers18010124

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Implication

Registry study reveals frequent delayed clearance and kidney injury across cancer patients receiving high-dose methotrexate, highlighting the necessity of diligent monitoring to prevent toxicity.

High-Dose Methotrexate at All Ages: Safety, Efficacy, and Outcomes from the HDMTX European Registry

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Implication

Key Points

Cite This Study

High-Dose Methotrexate at All Ages: Safety, Efficacy, and Outcomes from the HDMTX European Registry

Discussion

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Implication

Key Points

Cite This Study

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