Study of Glucarpidase (CPG2) for the Management of Patients With Delayed Methotrexate Clearance

Inclusion Criteria: * Written informed consent by patient or legally valid representative * Patients receiving high-dose MTX (\>1 g/m2 body surface area (BSA) given as an infusion over 24 hours) for the treatment of ALL, NHL or a solid tumour (e.g. osteosarcoma) * Age ≥ 18 years * Serum MTX \>5 µmol/L 42 hours or later after the start of MTX infusion, or serum MTX \>1 μmol/L 42 hours or later after the start of MTX infusion together with renal insufficiency, or serum MTX \>0.4 µmol/L 48 hours or later after the start of MTX infusion together with renal insufficiency. Renal insufficiency was defined as serum creatinine \>1.5 × the upper limit of normal (ULN) and/or oliguria (urine output \< 500 mL/24 hours despite adequate hydration, diuretics and alkalinisation). Exclusion Criteria: * Pregnant or lactating females * Unwillingness of patient or relative/legal representative to give informed consent