演題詳細

ポスター / Poster

ポスター 51 (Poster 51) :小児血液 (Pediatric Blood)

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F エメラルドABCD)
座長・司会
遠藤 幹也 (Mikiya Endo):1
1:岩手医科大学 小児科学講座
 
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A child of acute leukemia developing delayed excretion of methotrexate associated with deferasirox

演題番号 : PS-1-386

早瀬 朋美 (Tomomi Hayase):1、川原 勇太 (Yuta Kawahara):1、柏井 良文 (Yoshifumi Kashii):1、森本 哲 (Akira Morimoto):1

1:Department of Pediatrics, Jichi Children's Medical Center Tochigi, Japan

 

Introduction:Deferasirox is an oral iron chelation agent that is now widely available for the treatment for transfusional iron overload in adult and pediatric patients of 2 years of age or more. Although renal excretion of deferasirox and its metabolites is minimal, renal dysfunction is one of the major adverse effects of deferasirox. There is no official notification about interactions between deferasirox and renal excretory drugs. We experienced a child developing delayed excretion of methotrexate (MTX) associated with deferasirox in the course of high-dose (HD) -MTX therapy. Case report: A ten years old boy was diagnosed as acute biphenotypic leukemia and treated according to the Tokyo children's cancer study group (TCCSG) high risk ALL protocol. Desferasirox was administrated for high serum ferritin levels of more than 2,000 ng/mL. The protocol contains 3 courses of weekly 24hrs continuous HD-MTX (3 g/m2) infusion for CNS prophylaxis. At the first course of HD-MTX therapy, his serum MTX level at 48hr was as high as 7.1 μmol/L despite of appropriate hydration and alkylation. Oral deferasirox was stopped immediately. The MTX level was reduced to less than 0.1 μmol/L at 264hr. The following 2 courses of HD-MTX therapy was completed without significant delayed excretion of MTX. Discussion: Even without official notification about pharmacological interaction with HD-MTX, deferasirox could cause severe delayed excretion of MTX. Maybe we should not administrate deferasirox during HD-MTX therapy.

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