Table 2.
MTX-related toxicities and outcome
| N (%) or median (IQR) | Survivors n = 23 |
Non survivors n = 10 |
P value |
|---|---|---|---|
| MTX infusion | |||
| Median dose (g) | 7.4 [4.9–14] | 5.85 [5.1–10.5] | 0.814 |
| Time since ICU admission (days) | 4 [1–7] | 4 [2.2–8.7] | 0.335 |
| Interacting medications | |||
| Mean number of medications (sd) | 0.69 (0.89) | 0.8 (0.92) | 0.578 |
| Piperacillin-tazobactam | 4 | 4 | |
| Proton-pump inhibitors | 6 | 3 | |
| Levetiracetam | 4 | 0 | |
| MTX-related complications | 18 (78%) | 9 (90%) | 0.76 |
| Includinga | |||
| Acute kidney injury | 7 (30%) | 4 (40%) | |
| Mucositis | 15 (65%) | 6 (60%) | |
| Diarrhea | 6 (26%) | 8 (80%) | |
| Liver tests disturbances | 11 (48%) | 4 (40%) | |
| MTX concentrations (µmol/L) | |||
| MTX H24 | 3.1 [1.5–5.62] | 19.5 [6.2–29.4] | 0.052 |
| MTX H36 | 5.4 [3–7.7] | 16.7 [2.23–44.2] | 0.643 |
| MTX H48 | 0.4 [0.3–0.7] | 1.6 [0.6–5.9] | 0.103 |
| MTX H72 | 0.3 [0.1–0.4] | 0.6 [0.2–3.9] | 0.143 |
| MTX H96 | 0.07 [0.02–0.12] | 0.34 [0.26–1.25] | 0.013 |
| Specific treatments | |||
| Median dose of folinic acid rescue (mg) | 200 [200–200] | 320 [200–800] | 0.003 |
| Carboxypeptidase | 1 (4.3%) | 2 (20%) | 0.436 |
| Outcomes | |||
| Length of ICU stay (days) | 10 [6–18.5] | 19.5 [10.7–25] | 0.16 |
| Length of hospital stay | 64.5 [37–103] | 36 [29–72.7] | 0.13 |
| End of life decision | 2 (9%) | 9 (90%) | < 0.001 |
MTX methotrexate, ICU intensive care unit
aSome patients experienced several MTX-related complications