PMID: 6981054Jan 1, 1982Paper

Plasma phenylalanine: tyrosine ratios during high-dose methotrexate-citrovorum "rescue"

Medical and Pediatric Oncology
M A HiltonL W Clark

Abstract

We have measured phenylalanine and tyrosine in the plasma of patients with osteogenic sarcoma undergoing chemotherapy with high-dose methotrexate (HDMTX) citrovorum factor rescue (CFR). During 14 treatments in six different patients, the phenylalanine to tyrosine ratio (PHE/TYR) at 21 to 38 hours was elevated over pretreatment levels. The observed increase in plasma phenylalanine is attributed to inhibition by MTX of the phenylalanine hydroxylase system of the liver, which is not folate-dependent and thus is not corrected by administration of CV. A post-infusion increase in PHE/TYR of 571% after 22 hours in one patient and of 410% after 30 hours in another were associated with marked MTX toxicity. The greatest increase in PHE/TYR seen in a patient who did not experience toxicity was was 249% in 21 hours. Thus, in this group of patients, there appears to be a correlation between evidence of clinical MTX toxicity and the magnitude of the percentage increase in PHE/TYR in the plasma, which indicates inhibition of a liver enzyme and thus reflects the intracellular concentration of MTX.

References

Jan 1, 1979·Medical and Pediatric Oncology·C PerezJ Herson
Oct 1, 1979·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·H SauerW Wilmanns
Aug 1, 1976·Biochemical Medicine·M A HiltonC C Patel
Jul 25, 1968·The New England Journal of Medicine·R J WurtmanF F Larin
Feb 1, 1958·Proceedings of the Society for Experimental Biology and Medicine·M J OSBORNF M HUENNEKENS

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