A meta-analysis was conducted to estimate the risk of wound-healing complications in patients who treated with neoadjuvant-adjuvant bevacizumab in various oncological indications. We searched PUBMED, EMBASE and the Cochrane Library through June 2016 to identify randomized controlled trials of bevacizumab and wound-healing complications. Seven RCTs studies involving 5,147 participants were included in the analysis. Compared with routine therapy, bevacizumab increased the incidence of wound-healing complications for various cancers. The pooled estimate of odds ratio (OR) was 2.32, and the 95 % confidence intervals (CI) was 1.43 to 3.75. (P < 0.001). Subgroup analyses revealed the similar result in colon carcinoma patients. In conclusion, bevacizumab increases the incidence of wound-healing complications for cancers especially for colon neoplasms patients. However, the adverse effect is not appeared in breast cancer, metastatic renal cell carcinoma, non-small-cell lung cancer and gastro-oesophageal adenocarcinoma. Due to the findings relying chiefly on data from single or two studies, hence, further research is required to assess the wound-healing complications risk of bevacizumab in each oncological indication.

Aims: Although high-dose methotrexate (HDMTX) is an effective means for the treatment of acute lymphoblastic leukemia (ALL), the development of renal dysfunction remains a significant management challenge. This study aimed to identify the key factors in HDMTX-induced acute kidney injury (AKI) in childhood ALL. Methods: We retrospectively analyzed the clinical data in 1,329 courses of HDMTX treatment in 336 Chinese ALL children at the First Affiliated Hospital of Guangxi Medical University from September 2012 to November 2016. The clinical data were compared between the groups of children with development of AKI and those without. Risk factors were identified by multiple logistic regression analysis, and the diagnostic performance of plasma MTX concentration was evaluated by receiver operating characteristic (ROC) curve analysis. Results: AKI was observed in 88 patients (26.2%) and 104 courses (7.8%). Binary logistic regression revealed that age (OR 1.349; p = 0.005), first HDMTX course (OR 1.767; p = 0.013), MTX dose per body surface area (BSA; OR 1.944; p = 0.015), and baseline serum total protein (OR 0.929; p = 0.021) significantly correlated with AKI. The area under the ROC for 48-h plasma MTX concentration was 0.890 (95% CI 0.850–0.930), and sensitivity and specificity values of the cut-off value were 78.8 and 90.4%, respectively. Conclusion: Increasing age, higher MTX dose per BSA, lower baseline serum protein, and first HDMTX course were significant risk factors for developing HDMTX-induced AKI in childhood ALL. The threshold of 48-h MTX plasma concentration is valuable for the prediction of HDMTX-induced AKI.

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