Surdosage au méthotrexate : complications, prise en charge et prévention

High-dose methotrexate (HDMTX) is an important component in the treatment of a variety of solid tumors and hematological malignancies. To prevent potentially lethal toxicity, HDMTX is usually administered following preventive measures, using vigorous hydration and urine alkalinization to enhance MTX solubility as well as pharmacokinetically guided leucovorin rescue. We describe here practical guidelines for HDMTX administration and early detection and management of toxicities.