Early Urinary Potassium Level Predicts High-dose Methotrexate Elimination Delay in Primary Central Nervous System Lymphoma.

IF 1.6 4区医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-10-01 DOI:10.21873/anticanres.17272

Vincent Harlay, Alexandre Bertucci, Céline Boucard, Gregorio Petrirena, Chantal Campello, Maryline Barrié, Didier Autran, Olivier Chinot, Emeline Tabouret

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Abstract

Background/aim: Treatment of primary central nervous system lymphoma (PCNSL) includes high dose methotrexate-based polychemotherapy (HD-MTX). This study aimed to identify early predictive factors of methotrexate (MTX) delayed elimination.

Patients and methods: We prospectively included all patients with newly-diagnosed PCNSL. Daily serum and urinary creatinine and ionogram were collected. We generated two independent cohorts: a training cohort (TC) and a confirmatory cohort (CC).

Results: We included for analysis 64 cures of HD-MTX (20 patients) in the TC and 59 cures (22 patients) in the CC. Median elimination time of MTX was 95 h and 96 h in the TC and CC, respectively. In multivariate analysis, older age (p=0.004), low Karnofsky Performance Status (p=0.036) and high urinary K⁺ (p=0.001) were associated with delayed MTX elimination. An optimal cutoff for urinary K⁺ was defined. In the CC, we confirmed that high urinary K⁺ (p=0.004) remained associated with delayed MTX elimination.

Conclusion: High urinary K⁺ may be predictive of delayed MTX elimination in primary central nervous system lymphoma. Its relevance as a decision-making factor needs to be validated in additional prospective studies.

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原发性中枢神经系统淋巴瘤患者早期尿钾水平可预测大剂量甲氨蝶呤的消除延迟

背景/目的：原发性中枢神经系统淋巴瘤（PCNSL）的治疗包括基于甲氨蝶呤的大剂量多化学疗法（HD-MTX）。本研究旨在确定甲氨蝶呤（MTX）延迟消除的早期预测因素：我们前瞻性地纳入了所有新诊断的 PCNSL 患者。收集每日血清肌酐、尿肌酐和离子图。我们建立了两个独立队列：训练队列（TC）和确诊队列（CC）：结果：我们在 TC 中纳入了 64 例 HD-MTX 治愈患者（20 例）进行分析，在 CC 中纳入了 59 例治愈患者（22 例）进行分析。TC和CC中MTX的中位消除时间分别为95小时和96小时。在多变量分析中，年龄大（p=0.004）、卡诺夫斯基表现状态低（p=0.036）和尿 K+ 高（p=0.001）与 MTX 消除延迟有关。我们确定了尿 K+ 的最佳临界值。在CC中，我们证实高尿K+（p=0.004）仍与MTX消除延迟相关：结论：高尿 K+ 可预测原发性中枢神经系统淋巴瘤的 MTX 消退延迟。结论：高尿 K+ 可预测原发性中枢神经系统淋巴瘤的 MTX 消退延迟，但其作为决策因素的相关性还需要在更多的前瞻性研究中加以验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.