Leucovorin Rescue Doses in Acute Lymphoblastic Leukemia Patients Receiving High Dose Methotrexate

Abstract

Our aim is to determine the average Leucovorin (LV) doses given to Acute Lymphoblastic Leukemia (ALL) patients receiving High Dose Methotrexate in their consolidation phase of the treatment. An observational retrospective study was conducted in the inpatient department of Aware Gleneagles Global Hospital, Hyderabad, India. In a total of 73 pediatric and adult patients with Acute Lymphoblastic Leukemia (ALL) from various age groups who are in their Consolidation stage, comprising of 4 cycles each, containing a course high dose methotrexate from 2016-2021 were included in the investigation. All the data important was gathered from the patient case sheets and electronic clinical records in the planned patient's Performa or information assortment structure i.e., data collection which incorporates patient’s demographic subtleties, laboratory values, and so forth. Among the 73 subjects of ALL, the most average number of Leucovorin doses given in HDMTX is 6 among all the three subtypes of ALL diagnosis. It was also evident that there is an association between the HDMTX toxicity symptoms and age group, gender, diagnosis and HDMTX doses respectively. Consequently, we have concluded that number of leucovorin doses is correlated with the toxicity of methotrexate. The toxicity caused due to leucovorin can be cured with extraordinary degree by satisfactory and adequate hydration/Alkalinization, precise dose of anti-emetics and regular monitoring of Urine pH, Serum Creatinine, Serum Methotrexate levels, Complete Blood Count as to identify any toxicity and intense management of the toxicity.