Intracellular drug measurements to predict toxicity in high-dose methotrexate therapy in leukaemia and central
nervous system lymphoma.

High-dose Methotrexate (HD-MTX) chemotherapy is the cornerstone of the treatment of central nervous system lymphoma (PCNSL) and acute lymphoblastic leukaemia (ALL) . Although MTX is a relatively safe and effective drug, >35% of patients experience adverse events, which is poorly predicted by the highly variable plasma MTX levels. Intracellular MTX levels have been shown to correlate better with clinical outcome in ALL but are difficult to measure. Recently, we developed an intracellular MTX assay that can be used in routine clinical practice. We hypothesize that intracellular MTX levels predict toxicity in HD-MTX therapy. The aim of this study is to investigate A) cellular MTX pharmacokinetics and its determinants, and B) whether intracellular MTX levels are related to toxicity in adult HD-MTX administration.

intracellular MTX levels predict toxicity in HD-MTX therapy

Pre MTX
72 hours post MTX

bloodsampling