Abstract
A retrospective, single-center, observational study evaluated the difference in time to clearance of high-dose methotrexate between the fluorescence polarization immunoassay (FPIA) and ARK methotrexate assay in pediatric hematology/oncology patients. The post-ARK immunoassay group had an increase in clearance time of 33h/cycle and 31% increase in cycles with delayed clearance. On posthoc analysis, use of an adjusted clearance threshold of <0.15µmol/L post-ARK immunoassay, as opposed to the traditional <0.1µmol/L threshold, would have similar incidence of delayed clearance. The ARK immunoassay demonstrated a positive bias compared to the FPIA in clinical practice, which led to an institutional policy change.
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