Hemoperfusion for methotrexate removal

@article{Gibson1978HemoperfusionFM,
  title={Hemoperfusion for methotrexate removal},
  author={Thomas P. Gibson and Steven D. Reich and F A Krumlovsky and Peter Ivanovich and Chad Gonczy},
  journal={Clinical Pharmacology \& Therapeutics},
  year={1978},
  volume={23}
}
Removal of methotrexate by Amberlite XAD‐4 hemoperfusion was determined in a patient with metastatic breast carcinoma. During 4 hr of hemoperfusion the plasma concentration of methotrexate fell from 5.5 × 10−7 M to 3.1 × 10−7 M. After hemoperfusion methotrexate concentration increased as a consequence of multicompartmental pharmacokinetics to 5.5 × 10−7 M and then slowly declined. Plasma methotrexate clearance decreased from 79 mllmin 30 min into hemoperfusion to 28 mllmin at the conclusion. In… Expand
Removal of methotrexate, leucovorin, and their metabolites by combined hemodialysis and hemoperfusion
TLDR
The patient was effectively treated with repeated hemodialysis, charcoal hemoperfusion, leucovorin, and thymidine, and Gastrointestinal and hematologic toxicities were completely prevented, and serum creatinine normalized within 24 days. Expand
Effects of hemoperfusion plus high-flux hemodialysis in a patient with methotrexate toxicity
TLDR
The combination of hemoperfusion and hemodialysis resulted in good control of volume status, as well as improvement in serum chemistry values, in a case of osteosarcoma with lung metastasis treated with high-dose methotrexate as adjuvant chemotherapy. Expand
Present and future uses of hemoperfusion with sorbents.
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Evaluation of the role of hemoperfusion in hepatic encephalopathy or uremia is limited by the lack of knowledge regarding specific toxic molecules in these syndromes, but in the authors' series of ten patients with fulminant hepatic failure, four survived, in contradistinction to an 80–90% mortality for untreated patients, and virtually all awoke from deep coma. Expand
Charcoal Hemoperfusion for Methotrexate Toxicity: A Safe and Effective Life-Rescue Alternative When Glucarpidase Is Not Available
Background: High dose methotrexate (HDMTX) is used for the treatment of pediatric hemato-oncological diseases. HDMTX can induce acute kidney injury in cases of delayed elimination. The use ofExpand
Will hemoperfusion be useful for cancer chemotherapeutic drug removal?
TLDR
Preliminary experiments in the laboratory have shown that adriamycin may be efficiently removed by activated charcoal from aqueous and protein solutions and blood in vivo, and that daunorubicin is removed in vitro to the same extent, but previous clinical studies and data suggest that charcoal hemoperfusion has little utility unless a highly specific sorbent for methotrexate removal can be developed. Expand
Pharmacokinetics of Haemoperfusion for Drug Overdose
TLDR
Haemoperfusion may be useful in treating overdosage with ethchlorvynol or Phenytoin, particularly with high blood concentrations of drug, when the intrinsic clearance of the drug may be quite low due to non-linear metabolism. Expand
High-dose leucovorin as sole therapy for methotrexate toxicity.
  • C. Flombaum, P. Meyers
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1999
TLDR
In the range of MTX levels observed, HD LV can be used as a sole therapy for MTX toxicity without the need for extracorporeal removal and with tolerable morbidity. Expand
Successful rescue in a patient with high dose methotrexate-induced nephrotoxicity and acute renal failure.
TLDR
Conventional extrarenal procedures appear to have a limited role in the setting of overexposure to methotrexate in this case, and the use of very high doses of folinic acid in the case probably played a majorrole in the eventual favorable outcome. Expand
Removal of methotrexate by hemodiafiltration
TLDR
Although when these are assured, H D M T X can safely be given to most patients with normal renal function, significant toxicity and occasional fatalities can occur unexpectedly. Expand
Use of charcoal hemoperfusion with sequential hemodialysis to reduce serum methotrexate levels in a patient with acute renal insufficiency.
TLDR
Serum metotrexate levels were successfully lowered in a patient with methotrexate-induced acute renal failure by charcoal hemoperfusion and sequential hemodialysis, and no rebound in serum methotRexate levels was observed after perfusion, a phenomenon previously reported as limiting the usefulness of this procedure. Expand
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References

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TLDR
Column hemoperfusion with Amberlite XAD-4 resin was simpler and more effective than any known method of removing barbiturates and glutethimide from the blood of patients with drug overdoses. Expand
Resin hemoperfusion: a new treatment for acute drug intoxication.
TLDR
The resin-column hemoperfusion system used to treat four patients with profound, life-threatening drug intoxication was technically simpler, consistently more effective and clinically superior to hemodialysis. Expand
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TLDR
The observation that Mtx has a long terminal half‐life may explain the high incidence of tOXicity in patients receiving chronic low‐dose Mtx therapy. Expand
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TLDR
The reaction of the antiserum proved to be specific for methotrexate, as only insignificant interference could be demonstrated with folic acid, folinic acid (leucovorin), or tetrahydrofolic acid. Expand
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TLDR
In vitro clearance of PA, NAPA, quinidine, and phenobarbital by 11 clinically available artificial kidneys and an XAD‐4 hemoperfusion column was determined and differences were found, suggesting that both PA and NapA are removed not only from plasma but also from red blood cells. Expand
Methotrexate "escape" using charcoal hemoperfusion: An alternative to citrovorum "rescue
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Methotrexate removal by hemoperfusion 355 B.: Methotrexate "escape" using charcoal hemoperfusion: An alternative to citrovorum "rescue,
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RESIN REMOVAL OF DIGOXIN FROM DOGS
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