Dr. Vasundhara IyengarHematology & Oncology

Leucovoron rescue

1 min read
This is to reaffirm importance of leucovoron rescue  in patients with high dose Methotrexate therapy.
A patient with potentially curable DLBCL received high dose methotrexate as CNS prophylaxis in addition to usual stadard chemotherapy.
 Patient did not take needed leucovoron 24 hrs after completion of high dose Mtx Rx. She developed severe pancytopenia, mucositis and acute renal failure. She needed urgent hospitalisation for iv leucovoron. At 10x the prophylactic dose, alkalisation of urine.
Growth factor and antibiotic support. She did eventually recovered from acute toxicity. Renal function still abnormal slowly improving.
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A preventable complication associated with this therapy. It needs to be kept in mind.