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Folic and folinic acid load tests for dynamic assessments of compliance and metabolism in folate deficiency and hyperhomocysteinaemia patients unresponsive to high-dose folate replacement.
Ann Clin Biochem
January 2025
Clinical Haematology, New Cross Hospital, Black Country Pathology Services, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
We describe the utility of 'folic and folinic acid load tests' in the investigation of a 26-year-old woman with persistently low serum folate and moderate hyperhomocysteinaemia unresponsive to folic acid supplements. Serum folate, plasma 5-methyltetrahydrofolate (5-MTHF), red cell 5-MTHF and plasma total homocysteine at baseline, 2-h, 4-h and 2- or 4-days (if applicable) post administration of a large dose of oral folic acid, or oral or parenteral folinic acid were measured. The tests confirmed non-compliance but also suggested an unsuspected possible defect in the folate pathway based on differential response to folic versus folinic acid supplements.
View Article and Find Full Text PDFTherapeutic drug monitoring of methotrexate by disposable SPCE biosensor for personalized medicine.
Anal Chim Acta
January 2025
Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China; Department of Pharmacy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China. Electronic address:
Background: Methotrexate (MTX) is widely used in clinical practice for the treatment of malignant tumors and autoimmune diseases. High-dose MTX has been shown to be an effective approach for treating various malignant tumors, but it is accompanied by numerous toxic side effects, necessitating therapeutic drug monitoring (TDM) for patients and timely "folinic acid rescue." High-performance liquid chromatography and fluorescent immunoassay (FIA) are currently used to detect MTX, but these methods are limited by complex sample preparation, time consumption, and high cost.
View Article and Find Full Text PDFCetuximab-Induced Pneumonitis: An Overlooked Complication.
Cureus
October 2024
Pulmonary and Critical Care Medicine, St. Michael's Medical Center, Newark, USA.
Epidermal growth factor receptor (EGFR) inhibitors have largely been used for head and neck cancers, non-small cell lung cancers, and colorectal cancers (CRC). Reports of interstitial pneumonitis with EGFR inhibitors like gefitinib and erlotinib are present in the literature, but pulmonary toxicity with cetuximab has rarely been reported. We present a case of a 78-year-old male with metastatic CRC involving the brain and lungs who presented with severe pneumonitis, a month after treatment with cetuximab.
View Article and Find Full Text PDFResults of the prospective EORTC Children Leukemia Group study 58081 in precursor B- and T-cell acute lymphoblastic leukemia.
Hemasphere
November 2024
Département de Génétique Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Robert Debré Paris France.
Here, we report the results of the prospective cohort study EORTC-CLG 58081 and compare them to the control arm of the randomized phase 3 trial EORTC-CLG 58951, on which treatment recommendations were built. In both studies, patients aged 1-18 years with negative acute lymphoblastic leukemia of the B-lineage (B-ALL) or T-lineage (T-ALL) were treated using a BFM backbone without cranial irradiation. Similarly to the control arm of 58951, prednisolone (PRED) 60 mg/m/day was used for induction therapy, but a few modifications were made.
View Article and Find Full Text PDFSerum Methotrexate Level Predicts Acute Kidney Injury After High-Dose Methotrexate: A Case Report and Single-Center Experience.
Int J Nephrol Renovasc Dis
November 2024
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
Background: Acute kidney injury (AKI) is a serious complication following high-dose methotrexate (HD-MTX) treatment, despite established preventive measures. This study presents a case report and a retrospective review of patients treated with HD-MTX, aiming to identify risk factors for AKI and propose a modified treatment protocol.
Methods: We report a case of a 43-year-old man with diffuse large B-cell lymphoma who developed severe AKI after HD-MTX therapy.
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