{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:58:07Z","timestamp":1781618287791,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T00:00:00Z","timestamp":1592956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    High dose methotrexate (HDMTX)\u2010induced acute kidney injury (AKI) is a well\u2010known adverse event in hemato\u2010oncology patients. Our purpose was to define factors and setup cut\u2010offs that may help better identify patients at\u2010risk for developing AKI following HDMTX. All consecutive patients who received MTX dose \u22651\u2009g were retrospectively reviewed. We compared patients with or without renal toxicity. We used a logistic regression model to define baseline variables associated with AKI. Overall survival (OS) was estimated by the Kaplan\u2010Meier method employing log\u2010rank test. Between 2012 and 2017, 160 patients were included with a total of 265 courses. Indications included: primary central nervous system (CNS) lymphoma, CNS prophylaxis in other lymphoma types, acute lymphatic leukemia and others. Median age at diagnosis was 58\u2009years (range, 18\u201084), 54% were males, median MTX dose was 1941\u2009mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    (range, 743\u20105442) and AKI developed in 9% of drug administrations (n = 24). In univariate analysis: age\u2009&gt;\u200940, LDH\u2009&gt;\u2009380\u2009units\/L, eGFR\u2009&lt;\u2009112\u2009mL\/min, albumin &lt;3.6 mg\/dL at baseline and Charlson comorbidity index (CCI) were associated with AKI. In multivariable analysis, only LDH\u2009&gt;\u2009380\u2009units\/L (OR = 4.1, 95% confidence interval [CI] 1.04\u201020.9,\n                    <jats:italic>P<\/jats:italic>\n                    =\u2009.04) and albumin levels &lt;3.6 g\/dL (OR = 4.17, 95% CI 1.04\u20106.5,\n                    <jats:italic>P<\/jats:italic>\n                    =\u2009.04) remained significant. In patients with AKI, median drug elimination was longer (8\u2009days vs 5\u2009days). In 80% of cases, the creatinine levels returned to normal within 1 month. Yet, the median survival of patients who developed AKI was 37\u2009months, compared to 145\u2009months in patients without AKI (Log rank = 0.015). In conclusion, LDH\u2009&gt;\u2009380\u2009units\/L and albumin &lt;3.6 g\/dL were the strongest factors associated with AKI in patients receiving HDMTX. Although the rise in creatinine levels was almost uniformly reversible, AKI was associated with increased mortality rates.\n                  <\/jats:p>","DOI":"10.1002\/hon.2759","type":"journal-article","created":{"date-parts":[[2020,6,7]],"date-time":"2020-06-07T09:18:09Z","timestamp":1591521489000},"page":"584-588","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Risk factors for high\u2010dose methotrexate associated acute kidney injury in patients with hematological malignancies"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-5930","authenticated-orcid":false,"given":"Irina","family":"Amitai","sequence":"first","affiliation":[{"name":"Odette Cancer Center Sunnybrook Health Sciences Center  Toronto Ontario Canada"},{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uri","family":"Rozovski","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Hematology Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"El\u2010Saleh","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7245-9652","authenticated-orcid":false,"given":"Shai","family":"Shimony","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Hematology Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Shepshelovich","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Medicine I Tel Aviv Sourasky Medical Center  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benaya","family":"Rozen\u2010Zvi","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Nephrology and Hypertension Rabin Medical Center  Petah\u2010Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Raanani","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Hematology Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Gafter\u2010Gvili","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Hematology Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"},{"name":"Department of Internal Medicine A Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Gurion","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Hematology Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/42.8.1322"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.11-6-694"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0164"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1586\/17512433.2015.1045489"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1507547"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197709222971203"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.8.1667"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601472"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-008-0772-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn503"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200205000-00021"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20255"},{"key":"e_1_2_6_14_1","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE). 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