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Uptodate Reference Title
Indications for glucarpidase rescue in patients receiving therapy with high-dose methotrexate (MTX)*[1]
Indications for glucarpidase rescue in patients receiving therapy with high-dose methotrexate (MTX)*[1]
Infusion duration for high-dose MTX
Indication for glucarpidase rescue
≤24 hours
Serum creatinine significantly elevated relative to baseline measurement and:
36-hour plasma MTX concentration >30 microM
OR
42-hour plasma MTX concentration >10 microM
OR
48-hour plasma MTX concentration >5 microM
36 to 42 hours
48-hour plasma MTX concentration >5 microM
MicroM: micromolar. * Glucarpidase administration should optimally occur within 48 to 60 hours from the start of the high-dose MTX infusion.
Reference:
Ramsey LB, Balis FM, O'Brien MM, et al. Consensus Guideline for Use of Glucarpidase in Patients with High-Dose Methotrexate Induced Acute Kidney Injury and Delayed Methotrexate Clearance. Oncologist 2018; 23:52.