High-dose methotrexate blocks the metabolic pathways of conversion of homocysteine to methionine. As a result, homocysteine (hcy) accumulates in the blood. The aim of this study was to determine the relationship between changes in concentrations of hcy, mtx, and other criteria of toxicity in the key hours of therapeutic drug monitoring of mtx, as well as identifying the possibility of using hcy as a marker of toxicity and effectiveness of high-dose mtx therapy. The study includes data on 246 children with osteosarcoma of different localisation.

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