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Responses > Methotrexate Level Monitoring – Patients receiving Methotrexate

Freedom of Information request Methotrexate Level Monitoring – Patients receiving Methotrexate

Response published: 17 September 2025
Clinical Activity Data

FOI Request

I am writing to submit a request for information under the Freedom of Information Act 2000. I would be grateful if you could provide information regarding your hospitals clinical practice on the timing of methotrexate (MTX) level monitoring in patients receiving high-dose methotrexate (HDMTX) therapy. Specifically, I am seeking the following: Adult Patients 1. For adult patients with acute lymphoblastic leukaemia (ALL) receiving HDMTX, at what time point does your centre take the first MTX level? 2. For adult patients with osteosarcoma receiving HDMTX, at what time point does your centre take the first MTX level? 3. For adult patients with non-Hodgkin’s lymphoma receiving HDMTX, at what time point does your centre take the first MTX level? Paediatric Patients 1. For paediatric patients with acute lymphoblastic leukaemia (ALL) receiving HDMTX, at what time point does your centre take the first MTX level? 2. For paediatric patients with osteosarcoma receiving HDMTX, at what time point does your centre take the first MTX level? 3. For paediatric patients with non-Hodgkin’s lymphoma receiving HDMTX, at what time point does your centre take the first MTX level? Please note that I am not requesting any patient-specific data. This request relates solely to your clinical practice guidelines or standard protocols.

FOI Response

Freedom of Information Request – Ref: FOI 209-2025

Thank you for your recent Freedom of Information request. Please find our response below.

You asked:

Hospitals clinical practice on the timing of methotrexate (MTX) level monitoring in patients receiving high-dose methotrexate (HDMTX) therapy. Specifically, I am seeking the following:

Adult Patients
1. For adult patients with acute lymphoblastic leukaemia (ALL) receiving HDMTX, at what time point does your centre take the first MTX level?
2. For adult patients with osteosarcoma receiving HDMTX, at what time point does your centre take the first MTX level?
3. For adult patients with non-Hodgkin’s lymphoma receiving HDMTX, at what time point does your centre take the first MTX level?

Paediatric Patients
1. For paediatric patients with acute lymphoblastic leukaemia (ALL) receiving HDMTX, at what time point does your centre take the first MTX level?
2. For paediatric patients with osteosarcoma receiving HDMTX, at what time point does your centre take the first MTX level?
3. For paediatric patients with non-Hodgkin’s lymphoma receiving HDMTX, at what time point does your centre take the first MTX level?

Our response:

Gloucestershire Health and Care NHS Foundation Trust does not initiate or monitor high dose of methotrexate therapy.  Please re-direct your request to Gloucestershire Hospitals NHS Foundation Trust at ghn-tr.foi@nhs.net.

Next steps:

Should you have any queries in relation to our response, please do not hesitate to contact us. If you are unhappy with the response you have received in relation to your request and wish to ask us to review our response, you should write to:

Louise Moss
Head of Legal Services / Associate Director of Corporate Governance
c/o Gloucestershire Health and Care NHS Foundation Trust
Edward Jenner Court
1010 Pioneer Avenue
Gloucester Business Park
Brockworth, GL3 4AW
E-mail: louise.moss@ghc.nhs.uk

If you are not content with the outcome of any review, you may apply directly to the Information Commissioner’s Office (ICO) for further advice/guidance. Generally, the ICO will not consider your case unless you have exhausted your enquiries with the Trust which should include considering the use of the Trust’s formal complaints procedure. The ICO can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.