Incidence and management of patients with methotrexate delayed elimination in the clinical practice : A Delphi study
Gros, Luis (Hospital Universitari Vall d'Hebron)
Roldán-Pérez, Alicia (Hospital Universitario Infanta Sofía)
Cabero-Martínez, Almudena (Instituto de Investigación de Salamanca (IBSAL))
Domínguez-Pinilla, Nerea (Instituto de Investigación i + 12. Hospital 12 de Octubre)
De la Fuente, Adolfo (MD Anderson Cancer Center (Madrid))
González Barca, Eva (Hospital Universitari de Bellvitge)
Tasso, María (Hospital General Universitario de Alicante (Alacant, País Valencià))
Torrent, Montserrat (Institut d'Investigació Biomèdica Sant Pau)
Gallardo, Eva (BTG Specialty Pharmaceuticals)
del Cerro, Inés (Omakase Consulting S.L)
Giró-Perafita, Ariadna (Omakase Consulting S.L)
Badia, Xavier (Omakase Consulting S.L)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	High-dose methotrexate (HDMTX) is administered for the treatment of some cancers. HDMTX is usually safe but may crystallize in renal tubules causing acute kidney injury (AKI). Consequently, MTX elimination is delayed, resulting in a severe and life-threatening condition. No studies have been published about the impact of MTX toxicity in Spain. This study aims to estimate the incidence and management of MTX delayed elimination and toxicity. A two-round Delphi study was performed to reach consensus between 10 medical experts on haemato-oncology and paediatric oncology with experience in the management of HDMTX treated patients from leading Spanish hospitals. An online questionnaire was developed based on national and international guidelines and previous evidence regarding HDMTX-related toxicity. Consensus was established at 80% agreement. Median and interquartile ranges were calculated, and incidence data were extrapolated to the Spanish general population. Out of 1. 475 patients estimated to receive HDMTX treatment annually in Spain, 27. 5% present MTX delayed elimination and 11. 6% develop HDMTX-induced AKI (35. 4% with severe systemic toxicities (.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	High-dose methotrexate ; Acute kidney injury ; Clinical management ; Epidemiology ; Methotrexate delayed elimination
Publicat a:	Journal of Oncology Pharmacy Practice, Vol. 29 Núm. 4 (june 2023) , p. 794-801, ISSN 1477-092X

DOI: 10.1177/10781552221079568
PMID: 35147457

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