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
  1. aNegative value is due to a rerise of the MTX concentration.
  2. NA=not available.