Despite IV bicarbonate shortages, HDMTX can be administered safely with the implementation of several PO alkalization regimens for urinary alkalization. Our analysis is the largest prospective look at a PO alkalization method. While it has been attempted to decrease time to MTX administration, time to urine parameters, and ultimately length of stay, PO regimens do not appear to impact these objectives unless the oral alkalization regimen has been started prior to admission.16 Further prospective trials should be undertaken to establish the safety and efficacy of alternative PO alkalization regimens.


Preliminary data for this manuscript have been published online in the abstract only format ( Dr Michael Keng is a member for the Advisory Board for Agios, outside the submitted work.The authors report no other conflicts of interest in this work. 

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Daniel R. Reed,1 Eric J. Pierce,2 Jeremy M. Sen,3 Michael K. Keng1

1Division of Hematology/Oncology, Department of Medicine, University of Virginia, Charlottesville, VA, USA; 2Department of Medicine, University of Virginia, Charlottesville, VA, USA; 3Department of Pharmacy Services, University of Virginia, Charlottesville, VA, USA

Correspondence: Michael K Keng
University of Virginia, Department of Medicine, Division of Hematology/Oncology, 1300 Jefferson Park Avenue, West Complex, Room 6009, Charlottesville, VA 22908, USA
Tel +1 434 924 4257
Fax +1 434 244 7534


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Source: Cancer Management and Research.
Originally published August 30, 2019.