Observation And Prevention The Toxic Side Effects Of High-dose Methotrexate On Acute Leukemia In Children

AIM: To observe the toxic side effects of high-dose methotrexate(HD-MTX) on acute lymphoblastic leukenia(ALL), and to investigate the measures for preventing complications.METHODS: 40 children with ALL received 150 times HD-MTX treatment (3.0g/m~2,every time).The comprehensive measures for preventing complications were taken after chemotherapy. The clinical symptoms and the main toxic side effects were observed, and compare with the rate of mucositis and skin rash, the variation of WBC,PLT,ALT and CK-MB between adequate and inadequate hydration children.RESULTS: Gastrointestinal reaction, hepatic damage, dental ulcer, slight depression of bone marrow were the common adverse effects of HD-MTX. Compare to adequate hydration children, the incidence rate of mucositis and skin rash were higher, the variation of WBC,PLT were decreased significantly, and the variation of ALT were increased significantly in inadequate hydration ones (P<0.05). As for CK-MB, there was no significantly variance between inadequate hydration and adequate hydration children (P>0.05).CONCLUSION:Adequate hydration and alkalihization, correct calcium folinate rescue can reduce effectually the rate of the toxic side effects of HD-MTX .