{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:41:26Z","timestamp":1777934486537,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Methotrexate intoxication following high-dose methotrexate-induced acute kidney injury is a life-threatening complication. Glucarpidase can quickly reduce extracellular methotrexate to safe levels, but the effectiveness and safety of its use in different episodes of nephrotoxicity remain an unknown area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>A 30-year-old male diagnosed with acute lymphoblastic T-cell lymphoma received methotrexate 5\u2009g\/m2 intravenous (IV) as part of the first consolidation cycle. On Consolidation 3, he restarted methotrexate at a dose of 3\u2009g\/m2 IV showing slow methotrexate elimination, associated myelosuppression, and hepatic toxicity. Glucarpidase was administered (total dose of 2000 International Units (IU)). No adverse events were observed, and his renal function returned to normal. One hundred and six days later, he was diagnosed with leptomeningeal and cerebellar relapse and treatment with methotrexate 3,5\u2009g\/m2 IV day 1 and cytosine arabinoside (Ara-C) 2\u2009g\/m2 IV twice per day days 1, 3, and 5 was started. At 36\u2009h from methotrexate infusion, serum creatinine increased up to 1.89 mg\/dL and methotrexate concentration was 100\u2009\u00b5mol\/L. Management and Outcome: Ara-C was suspended, and a second administration of glucarpidase (2000 IU) was dispensed. No adverse events were noticed, methotrexate levels decreased and renal function progressively improved, recovering completely three\u2009weeks later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The effectiveness and safety of the use of glucarpidase in different episodes of nephrotoxicity remain an unknown area, and the rate and consequences of antiglucarpidase antibody formation remain poorly understood. This case report is, to our knowledge, the first case of a second administration of glucarpidase in a different cycle of high-dose methotrexate in an adult patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155220946464","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:53:01Z","timestamp":1596156781000},"page":"734-738","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["A second administration of glucarpidase in a different cycle of high-dose methotrexate: Is it safe and effective in adults?"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9130-3303","authenticated-orcid":false,"given":"Amalia","family":"Domingo-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Osorio","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Landete","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Monsalvo","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose L.","family":"D\u00edez-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"bibr1-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2017-0243"},{"key":"bibr2-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2710.2008.00966.x"},{"key":"bibr3-1078155220946464","first-page":"36","volume":"76","author":"Boelens AD","year":"2018","journal-title":"Neth J Med"},{"key":"bibr4-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1177\/1060028014526159"},{"key":"bibr5-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1507547"},{"key":"bibr6-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.11-6-694"},{"key":"bibr7-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0164"},{"key":"bibr8-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27378"},{"key":"bibr9-1078155220946464","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-11-1299"},{"key":"bibr10-1078155220946464","unstructured":"BTG International, Inc. 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