Table 4 Characteristics of patients who died related to MTX intoxication
From: Carboxypeptidase G2 rescue in patients with methotrexate intoxication and renal failure
| Case | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
| Diagnosis | Histiocytoma | NHL | ALL | Osteosarcoma |
| Age (years) | 39.4 | 10.2 | 5.7 | 19.1 |
| Time of death (days after MTX start) | 7 | 14 | 21 | 22 |
| Causes of death | Septic, multiorgan failure | Septic, multiorgan failure | Septic, multiorgan failure, progressive underlying disease, haemorrhage due to pulmonary aspergillosis | Cardiopulmonal failure due to severe anaemia, being Jehovah witness |
| MTX therapy | 12 g m−2 4 h−1 | 5 g m−2 24 h−1 | 1 g m−2 36 h−1 | 12 g m−2 4 h−1 |
| Contact after MXT start (h) | 32 | 140 | 49.5 | 19 |
| MTX level prior to first CPDG2 (μ M) | 688 | 9.2 | 4.58 | 814.6 |
| Creatinine concentration prior to first CPDG2 administration (μmol l−1) | 194.7 | 150.5 | 69 | 327.5 |
| Maximum creatinine level (μmol l−1) | 230.1 | 416 | 85.8 | 567.3 |
| Dose of first CPDG2 (U kg−1) | 54 | 45 | 50 | 47 |
| Time after MTX start (h) | 37.5 | 143.5 | 50 | 25 |
| MTX level (μ M)/MTX decrease (%) after CPDG2 | 82.8/88 | 0.85/91 | 1.46/86 | 86.1/90 |
| MTX level prior to second CPDG2 (μ M) | NA | 3.1 | 86.1 | |
| Dose of second CPDG2 (U kg−1) | 54 | 22 | 47 | |
| Time of second CPDG2 after MTX start (h) | 39 | 192 | 28.5 | |
| MTX level (μ M)/MTX decreasea (%) after second CPDG2 | NA | 0.94/70 | 87.5/−1.6a | |
| Leucovorin rescue | Adequately | Not known | Adequately | Adequately |
| Haemodialyse/haemofiltration (days) | 3 | 8 | 5 | |
| Start of haemodialysis after MTX infusion (h) | 55 | 171 | 24 | |
| Severe myelosuppression | No | Yes | Yes | Yes |
