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UK-VRX-2600029 Date of Last Revision: February 2026

MTX and HDMTX
uses

MTX

  • Cytotoxic agent used for treatment of malignancies since the 1950s1
  • Interferes with DNA synthesis in cancer cells, which is necessary for cancer cell growth and survival2

HDMTX

  • Commonly used to treat several adult and paediatric cancers2,3-6
Burkitt lymphoma
Primary central nervous system (CNS) lymphoma
Diffuse large B-cell lymphoma
Adult acute lymphoblastic leukaemia (ALL)
Paediatric ALL
Osteosarcoma

Abbreviations: ALL, acute lymphoblastic leukaemia; CNS, central nervous system; HDMTX, high dose methotrexate; MTX, methotrexate.

References

  1. Bleyer WA. The clinical pharmacology of methotrexate. New applications of an old drug. Cancer. 1978;41(1):36-51.
  2. Hagner N, Joerger M. Cancer chemotherapy: targeting folic acid synthesis. Cancer Management and Research. 2010;2:293-301.
  3. Casali PG, et al. Bone sarcomas: ESMO-PaedCan-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):iv79-iv95.
  4. Tilly H, et al. Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):v116-25.
  5. Hoelzer D, et al. Acute lymphoblastic leukaemia in adult patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(suppl 5):v69-v82.
  6. Ramsey LB, et al. Consensus guideline for use of glucarpidase in patients with high-dose methotrexate induced acute kidney injury and delayed methotrexate clearance. Oncologist. 2018;23(1):52-61.

UK-VRX-2600031 Date of Last Revision: February 2026