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1. Complications of tumour overkill when associated with high dose methotrexate therapy.

Author

Bell R, Forbes IK, Sullivan JR, and Hurley TH

Subjects
Adolescent, Adult, Calcium metabolism, Humans, Leucovorin therapeutic use, Lymphoma, Large B-Cell, Diffuse drug therapy, Male, Methotrexate administration & dosage, Middle Aged, Phosphates metabolism, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Methotrexate adverse effects
Abstract

Three patients, in whom tumour overkill by cytotoxic treatment, including high dose methotrexate with folinic acid rescue, resulted in the 'phosphate shower syndrome' (hyper-uricaemia, hyperkalaemia and hyperphosphataemia with hypocalcaemia and tetany, with metabolic acidosis and acute renal impairment) are described. Severe methotrexate toxicity occurred in two of these patients. High dose methotrexate would appear contra-indicated in situations where massive tumour lysis is possible.

Published
1979

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