Keywords

Methotrexate, Pediatric Oncology, Toxicity, Clearance, Demographic Factors, Body Surface Area

Abstract

High-dose methotrexate (HD MTX) is critical for treating pediatric malignancies such as acute lymphoblastic leukemia and neuro-carcinoma. However, its significant toxicity due to drug accumulation poses substantial risks. This retrospective study assesses the impact of demographic factors on MTX toxicity and clearance in pediatric oncology patients. Patient records from Saint Mary Hospital were analyzed, focusing on two MTX administration protocols: a 24-hour infusion followed by alkaline hydration and a 4-hour infusion followed by alkaline hydration. We hypothesize that factors such as age, body surface area (BSA), and body mass index (BMI) are associated with MTX clearance and toxicity. The study found no significant difference in clearance between genders, but females exhibited higher toxicity rates. Ethnicity comparisons showed Caucasians had the fastest clearance, followed by Hispanics, African Americans, and others, with Hispanics experiencing the highest toxicity rates. Patients with a BSA of less than one had a lower risk of delayed clearance, although toxicity levels were similar across BSA groups. BMI analysis indicated that patients with a BMI over 25 were at a higher risk of toxicity. Taken together, these findings suggest the need for personalized treatment plans in pediatric oncology to enhance therapeutic efficacy and reduce adverse effects. Future research should expand the sample size and develop a risk stratification guideline to identify patients suitable for outpatient treatment.

Thesis Completion Year

2024

Thesis Completion Semester

Summer

Thesis Chair

Flores-Otero, Jacqueline

College

College of Health Professions and Sciences

Thesis Discipline

Pediatric Oncology

Language

English

Access Status

Open Access

Length of Campus Access

None

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Rights Statement

In Copyright