In methotrexate therapy, what is a serious hematological complication?

Methotrexate, an antifolate medication commonly used in the treatment of various malignancies and autoimmune diseases, is associated with several hematological complications due to its effects on rapidly dividing cells. Among these complications, pancytopenia is particularly significant.

Pancytopenia refers to a reduction in the number of red blood cells, white blood cells, and platelets. This condition occurs because methotrexate can suppress bone marrow function, leading to decreased production of these blood cells. The suppression of myelopoiesis, the process of forming blood cells in the bone marrow, can result in anemia, increased risk of infections due to leukopenia, and bleeding tendencies related to thrombocytopenia.

Monitoring blood counts is a crucial part of the management of patients receiving methotrexate to prevent and promptly address this potential complication. Diligent monitoring allows for dose adjustments or the initiation of supportive care, such as folic acid supplementation or the discontinuation of therapy if necessary.

In summary, the hematological complication of pancytopenia in patients on methotrexate therapy is noteworthy due to the drug's impact on bone marrow suppression, requiring careful monitoring and management to mitigate this risk.