New Therapeutic Approach to Reduce Methotrexate Toxicity after High-Dose Chemotherapy in a Child with Acute Lymphocytic Leukemia: Efficacy and Safety of Hemoadsorption with HA-230 Adsorber

Sazonov V. Tobylbayeva Z. Saparov A. Jubaniyazov B. Issakov S. Gaipov A.
1 January 2022 S. Karger AG

Blood Purification
2022 #51 Issue 1 91 - 95 pp.

Background: High-dose methotrexate (HDMTX) is likely to cause a number of side effects and manifest itself as hepatotoxicity, nephrotoxicity, mucositis, and neurotoxicity. A several studies demonstrated the efficacy of extracorporeal detoxification methods such as plasma exchange, hemodialysis (HD), HD filtration, and hemoperfusion for the treatment of MTX delayed clearance. However, none of the existing methods as effective as expected and limited for general implementation due to a procedure-related complication. Case Report: Here, we report a successful implementation of HA-230 hemoadsorption procedure to remove cumulated MTX from the body and reduce its toxicity in a child with ALL after high-dose chemotherapy. Results and Conclusion: Based on our results, single-hemoadsorption procedure with the HA-230 adsorber in case of delayed methotrexate clearance was safe and well-tolerated in a pediatric patient with ALL and would significantly improve the patients condition. Further studies need to demonstrate its safety and efficacy in a large number of pediatric patients.

Blood purification , HA-230 adsorber , Hemoadsorption , High-dose methotrexate therapy , Methotrexate

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Pediatric Anesthesiology and Intensive care Unit, University Medical Center, National Research Center for Maternal and Child Health, Nur-Sultan, Kazakhstan
Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
Department of Clinical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
Biomedical Sciences, Nazarbayev University School of Medicine, #5/1 Kerei, Zhanibek Khandar St., Nur-Sultan, Z05K4F4, Kazakhstan

Pediatric Anesthesiology and Intensive care Unit
Department of Biomedical Sciences
Department of Clinical Sciences
Biomedical Sciences

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