Delayed excretion of high-dose methotrexate in pediatric acute leukemia correlates with laxative and constipation management.

ABSTRACT:

Background

Delayed excretion of high-dose methotrexate (HD-MTX) in pediatric acute lymphoblastic leukemia (ALL) can result in significant morbidity. While methotrexate is primarily renally excreted, HD-MTX may overwhelm renal excretion and increase reliance on fecal elimination. This study evaluated the association between laxative use for constipation and delayed excretion of HD-MTX.

Methods

This multisite chart review included pediatric patients with ALL (2010-2020) who received HD-MTX (5 g/m²). Delayed excretion was defined as a serum MTX concentration greater than 0.4 µM at Hour 48. We identified use of laxative medications after each HD-MTX infusion, with receipt of two or more doses considered a proxy for constipation. Multilevel logistic regression models e

SUBMITTER: Belsky JA 

PROVIDER: S-EPMC11803646 | biostudies-literature | 2025 Jan

REPOSITORIES: biostudies-literature