| Objective:To investigate the effect of high dose methotrexate(HD-MTX)on pancreatic exocrine function in children with acute lymphoblastic leukemia(ALL).To understand ALL children after HD-MTX chemotherapy,serum amylase,lipase exists,and collect the children whether after chemotherapy in acute pancreatitis related symptoms of digestive system,further analysis ALL children after HD-MTX chemotherapy,whether acute pancreatitis.Early identification and timely treatment of children with methotrexate induced pancreatitis were performed,and the time of pancreatitis at different doses was compared to guide the safety of subsequent clinical medication.Methods:A total of 20 patients with acute lymphoblastic leukemia was treated with high-dose methotrexate,who received 29 times 3-5g/m2,were enrolled in the study.The clinical manifestations of children after HD-MTX were closely monitored,and serum amylase and serum lipase were investigated and recorded before and after methotrexate treatment,and data were collected at 68h after HD-MTX.The correlation between two variables was analyzed by SPSS 19 software Spearman correlation.Results:20 children with acute lymphoblastic leukemia were treated with 29 HD-MTX chemotherapy,Abdominal pain occurred within 24 hours after chemo-therapy in 1 cases,After 24 hours of abdominal pain,the serum lipase(the 68 hour serum lipase after the beginning of HD-MTX)decreased compared with that before chemotherapy.9 cases had vomiting,of which 6 cases occurred within 24 hours after HD-MTX chemotherapy,and 1 cases of serum lipase after 24 hours of vomiting(HD-MTX after 68 hours of serum lipase)were higher than before chemotherapy,in the normal range,5 cases decreased before chemotherapy,and 3 cases of vomiting occurred after HD-MTX chemotherapy began.Within 24～48 hours,the corresponding 68 hour serum lipase was lower than that before chemotherapy.amylase was normal in 68 hours.There was no significant difference in serum amylase before and 68h after chemotherapy among all the children with acute lymphoblastic leukemia treated with HD-MTX chemotherapy.There was significant difference in serum lipase before and 68h after chemotherapy.There was no significant difference in serum amylase and lipase before and 68h after chemotherapy in MTX 3g/m2 and 4-5g/m2 group.Conclusion:After HD-MTX chemotherapy,there were a few cases of abdominal pain and vomiting,which were related to gastrointestinal reaction after chemotherapy HD-MTX has an effect on the pancreatic exocrine function of ALL children and is related to the dose of methotrexate.Children with ALL has no acute pancreatitis associated digestive symptoms occur,and their serum amylase and lipase have not more than 3 times increase than the normal upper limit during the observation period after HD-MTX chemotherapy. |
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