close
TABLE 1. Sample HDMTX Protocols in Pediatric and Adult Cancers
Author/ Year MTX Dose MTX Infusion Duration Leucovorin Rescue Dose Start of Leucovorina
ALL
Takeuchi 20026 100 mg/m2 bolus, then 500 mg/m2 as a 4-hour infusion 4 hours 15 mg every 6 hours for 8 doses 28 hours
Linker 20027 220 mg/m2 bolus, then 60 mg/m2 per hr x 36 hours 36 hours 50 mg/m2 IV every 6 hours for 3 doses, then orally until serum MTX < 0.05 μM 36 hours
Han 20018; Hill 20049 8 g/m2 (age ≤ 4)
6 g/m2 (age > 4)
10% bolus, remainder over 23 hours 15 mg/m2 every 3 hours, then every 6 hours when serum MTX
< 2 x 106 μM
36 hours
Pui 200410 2 g/m2 2 hours 10 mg/m2 every 6 hours 44 hours
Asselin 20113 5 g/m2 (0.5 g/m2 bolus over 30 minutes, then 4.5 g/m2 over 23.5 hours) 24 hours 75 mg/m2 then 15 mg/m2 every 6 hours until serum MTX ≤ 0.1 μM 36 hours
CNS Lymphoma
Ferreri 20094; Joerger 201011 3.5 g/m2 (0.5 g/m2 in 15 minutes, then 3 g/m2 as a 3- hour infusion) 3 hours, 15 minutes 15 mg/m2 every 6 hours for 12 cycles or until serum MTX levels are undetectable 24 hours
Osteosarcoma
Souhami 199712 8 g/m2 (≥ 12 years old)
12 g/m2 (< 12 years old)
Not specified 12 mg/m2 IV or 15 mg/m2 orally every 6 hours for 10 doses 24 hours
Fuchs 199813 12 g/m2 (maximum 20 g) Not specified 15 mg/m2 every 6 hours for 12 doses Not specified
Bacci 200114 12 g/m2 (escalate to 14 g/m2 if 6-hr serum MTX < 1 μM) 6 hours 15 mg every 6 hours for 11 doses 24 hours
Goorin 200315 12 g/m2 4 hours 15 mg every 6 hours for 10 doses 24 hours
Ferrari 200516 12 g/m2 4 hours 8 mg/m2 every 6 hours for 11 doses 24 hours
Holmboe 201217 Mean dose, 12 g/m2
(range, 8-16 g/m2)
4 hours Standard dosing until serum MTX ≤ 0.2 μM 24 hours