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Pediatrics

Methotrexate Toxicity in Pediatric Acute Lymphoblastic Leukemia Linked to Visceral Fat and Body Fat

Strategic Insights

— 1 min read

Research published in Pediatric Blood & Cancer has identified a significant association between visceral fat area and body fat mass with an increased risk of methotrexate toxicity in pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma. The study, conducted by researchers at the Nacional Institute of Pediatrics, found that patients with a high visceral fat area and high body fat mass were more likely to experience late toxicity, including severe cases.

Key Takeaways:

  • The study included a cohort of 100 patients aged 6-18 years diagnosed with acute lymphoblastic leukemia and lymphoblastic lymphoma who received high-dose methotrexate without prior toxicity.
  • Visceral fat area (VFA) ≥ 47 cm was associated with a significantly higher risk of late toxicity (RR 2.8, p = 0.01) and severe late toxicity (RR 5.6, p = 0.003).
  • High body fat mass was also found to be a significant risk factor for late toxicity (RR 2.0, p = 0.01) and severe late toxicity (RR 2.3, p = 0.03).
  • No significant associations were found with low phase angle, low skeletal muscle index, or overweight body mass index.

Statistics:

  • 30.2% of methotrexate toxicity events occurred early, and this figure increased to 58.7% for late toxicity.
  • Patients with VFA ≥ 47 cm had a 2.8-fold increased risk of late toxicity (RR 2.8, p = 0.01).
  • Patients with high body fat mass had a 2-fold increased risk of late toxicity (RR 2.0, p = 0.01).
  • The correlated risk of severe late toxicity was 5.6-fold for VFA ≥ 47 cm (RR 5.6, p = 0.003) and 2.3-fold for high body fat mass (RR 2.3, p = 0.03).

Sources:

  • Visceral Fat and Body Fat as Risk Factors for Methotrexate Toxicity in Pediatric Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma. Pediatric Blood & Cancer, 2025.
  • Nacional Institute of Pediatrics, Mexico City, Mexico. Ximena Monserrat Torreblanca-Garcia, Servicio De Oncologia Medica, National Institute of Pediatrics, Mexico City, Mexico.
  • Pediatric Blood & Cancer, Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

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