Evidence mapPaperPMID 41824102Full record

ArticleAnnals of hematology2026

Role of cystatin C in predicting the risk of hypermethotrexemia and kidney injury after high-dose methotrexate chemotherapy in childhood acute lymphoblastic leukemia.

Wenting Pei, Xiao Zhang, Li-An Du, Zhijuan Liu, Li Song, Muyuan Ji, Xiao Mou, Luping Ding, Fu Li, Xiaoling Li and 1 more

Abstract read
In one paragraph

Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Wenting PeiDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Xiao ZhangDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Li-An DuDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Zhijuan LiuDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Li SongDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Muyuan JiDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Xiao MouDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Luping DingDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Fu LiDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Xiaoling LiDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China.
Xiaomei YangDepartment of Pediatric Hematology & Oncology, Children's Hospital, Shandong University (Jinan Children's Hospital), Jinan, 250022, China. yangxiaomeijnetyy@163.com.

Funding

Science and Technology Development Program of Jinan Municipal Health Commission 2024304013
6 · The paper itself

Abstract

This study analyzed the correlation among serum cystatin C (CysC) levels, hypermethotrexemia, and kidney damage following high-dose methotrexate (HD-MTX) chemotherapy in children with acute lymphoblastic leukemia (ALL) to aid early prediction, diagnosis, and treatment. Clinical data from 103 children diagnosed with ALL were collected, totaling 412 HD-MTX chemotherapy sessions. The association between 20-h serum CysC levels, 44-h MTX blood concentrations, and 44-h serum creatinine levels was analyzed. Forty-four patients in the low-risk group received 3 g/m2 of HD-MTX, while 59 patients in the intermediate-risk group received 5 g/m2 of HD-MTX. Some patients experienced a 20% dose reduction due to high 44-h MTX concentrations in previous cycles; however, no dose increases were observed. In the high MTX concentration group, 31.4% (27/86) of patients had elevated 20-h serum CysC levels, significantly higher than the 2.8% (9/324) in the low-concentration group (P < 0.001). However, baseline serum CysC levels did not differ significantly (P = 0.377). Among the 36 cycles with elevated 20-h serum CysC levels, 19.4% (7/36) of patients progressed to elevated serum creatinine levels at 44 h. In contrast, only one patient in the normal serum CysC group showed such progression (P < 0.001). Furthermore, the 20-h serum CysC levels positively correlated with 44-h MTX concentrations and serum creatinine levels. Our findings indicate that 20-h serum CysC levels can predict hyperammonemia and kidney injury.

Indexed as

Acute Kidney InjuryAntimetabolites, AntineoplasticCystatin CMethotrexatePrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentChildChild, PreschoolCreatinineFemaleHumansInfantMaleRetrospective StudiesAntimetabolites, AntineoplasticCreatinineCST3 protein, humanCystatin CMethotrexateAcute lymphoblastic leukemiaCystatin CHigh-dose methotrexate chemotherapyHypermethotrexemiaKidney injuryRisk assessment

Identifiers

PMID41824102
PMCPMC12987861

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.