Long‐term follow‐up of renal function after high‐dose methotrexate treatment in children

Abstract

Our results show that HD-MTX treatment significantly decreases GFR and may cause albuminuria in pediatric cancer patients several years after treatment. Long-term renal follow-up of these patients is therefore important.

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

“…387,388 Similarly, methotrexate therapy has been associated with long-term renal impairment. 389,390 Although an association between cisplatin and hypertension has been reported among adult testicular cancer survivors, 376,391-393 a similar association has not been reported in childhood cancer survivors. 31,394 In a small, nested case-control study (44 case subjects, 123 control subjects), Cardous-Ubbink et al 395 found a modest but nonsignificant association between hypertension and cisplatin therapy; however, the lack of an association may be the result of the relatively small sample of survivors treated with cisplatin studied to date.…”

Glomerular Function Time Trends in Long-Term Survivors of Childhood Cancer: A Longitudinal Study

“…It has been suggested that CCS treated with ifosfamide, cisplatin, carboplatin, high-dose (HD-)methotrexate, HD-cyclophosphamide, radiotherapy to the kidney region, and/or (partial) nephrectomy are at risk for nephrotoxicity (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Recently, we showed in a large cross-sectional cohort study, including 1,442 CCS with a median followup of 12 years after diagnosis, that 28% had 1 renal late effect (s), of whom, 62 (4.6%) developed glomerular dysfunction (GFR <90 mL/min/1.73 m 2 ).…”

Late effects of chemotherapeutic agents on renal function in childhood cancer survivors: a review of the literature

“…The authors concluded a statically significant inverse relationship existed between follow-up time and GFR. As the followup time increased, the authors noted a statistically significant decrease in GFR [4]. A key strength of this study is the length of follow-up (see Fig.…”

“…Ultimately, more extensive evaluation of the potential longterm complications of chemotherapy induced renal toxicity is required to support screening and management of late effects in clinical practice. Gronroos et al conducted a cohort study evaluating renal function in 28 patients who used high dose methotrexate therapy [4]. The aim of this study was to investigate long-term deterioration in renal function following high dose methotrexate treatment in pediatric patients treated for leukemia and lymphoma.…”