Clinical observation of adverse reactions of high-dose methotrexate in the treatment of children with acute lymphoblastic leukemia

Objective: To investigate the clinical adverse reactions of high-dose methotrexate(HD-MTX) in the treatment of children with acute lymphoblastic leukemia(ALL).Methods: Forty cases of children with ALL were treated with HD-MTX(2.0-5.0 g/m²).The clinical signs and symptoms were observed and the incidence rates of adverse reactions were counted.Results: After three courses of treatment,some adverse reactions,such as,bone marrow suppression,gastrointestinal reactions,infection,liver injury,mucosal damage,heart damage,neurological symptoms,rash and alopecia appeared.The incidence rate of bone marrow suppression,gastrointestinal reactions,infection,liver injury,mucosal damage,heart damage,neurological symptoms,rash and alopecia was 61.3%,51.9%,38.1%,41.3%,15.6%,10.0%,15.0%,6.9% and 5.0%,respectively,but obvious renal injury did not appear.Conclusions: There were many adverse reactions of HD-MTX in the treatment of children with ALL,and it is important to carry out active symptomatic treatment,strengthen the monitoring of plasma concentrations of MTX and individualize treatment protocols,in order to increase the rate of long-term disease free survival.