Extremely high concentration of mexotrexate in blood serum leading to development of acute renal failure in a patient with acute lymphoblastic leukemia after high-dose consolidation

Abstract

Acute renal failure (ARF) is one of rare and severe methotrexate(MT)-induced complications in patients with acute lymphoblastic leukemia. A case of MT-induced renal dysfunction with an extremely high serum MT concentration is reported. This toxicity required conduction of hemodiafiltration for extracorporeal MT elimination. The presence of homozygous mutation of methylene-tetrahydrofolate reductase reflects an individual metabolism of MT and its renal clearance.

About the authors

Mariya Anatol'evna Pimenova

Email: maria_pimenova@mail.ru

Andrey Nikolaevich Sokolov

Email: cat@blood.ru

Lyudmila Semenovna Biryukova

Email: birjukova@blood.ru

Elena Nikolaevna Ustinova

Inna Ivanovna Shaforostova

Email: shiil@yandex.ru

Irina Anatol'evna Donskova

Email: irina.donskova99@mail.ru

Rashit Fargatovich Bogdanov

Email: rashit85@mail.ru

Elena Nikolaevna Parovichnikova

Email: elenap@blood.ru

Valeriy Grigor'evich Savchenko

Email: svg@blood.ru

M A Pimenova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

A N Sokolov

Hematological Research Center, Moscow

Hematological Research Center, Moscow

L S Biryukova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

E N Ustinova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

I I Shaforostova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

I A Donskova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

R F Bogdanov

Hematological Research Center, Moscow

Hematological Research Center, Moscow

E N Parovichnikova

Hematological Research Center, Moscow

Hematological Research Center, Moscow

V G Savchenko

Hematological Research Center, Moscow

Hematological Research Center, Moscow

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