Delayed Methotrexate Elimination after Administration of a Medium Dose of Methotrexate in a Patient with Genetic Variants Associated with Methotrexate Clearance

Yasuhisa Tatebe, Kiichiro Kanamitsu, Hirotaka Kanzaki, Hisashi Ishida, Kaori Fujiwara, Kana Washio, Yoshihisa Kitamura, Toshiaki Sendo, Akira Shimada, Hirokazu Tsukahara

Research output: Contribution to journalArticlepeer-review

Abstract

Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the administration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dysfunctional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner.

Original languageEnglish
Pages (from-to)545-550
Number of pages6
JournalActa medica Okayama
Volume74
Issue number6
Publication statusPublished - 2020

Keywords

  • acute kidney injury
  • acute lymphoblastic leukemia
  • drug elimination
  • methotrexate
  • polymorphism

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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