Estimated doses of folinic acid after methotrexate high dose in hematologic malignancies

Abstract

Author(s): Zainab Mustafa Mahdi*

Folinic acid is a metabolically active reduced form of folate that bypasses dihydrofolate reductase. Folate supplementation indications include the prevention of several diseases such as ulcerative colitis, neural tube defects, and cognitive dysfunction in the elderly. As a derivative of folic acid, folinic acid is useful as an antidote to folic acid antagonists (i.e., methotrexate, pyrimethamine). Folinic acid may be administered to counteract the potential toxicity of methotrexate that escapes into the systemic circulation. A clinical prospective follow up study conducted in Baghdad Hematology center of Medical city during the period from 1st of November, 2018 to 20th of April, 2019on sample of 53 Iraqi patients with hematological malignancy. The diagnosis of acute lymphoblastic leukemia or non-Hodgkin's lymphoma was done by the physicians through proper investigations. The Methotrexate dose and infusion rate were designed by the protocols. The patients were followed through serum collection and estimation of Methotrexate level by Abbut Machine and followed by administered the folinic acid doses based on Methotrexate level. MTX serum level should be measured after 24, 48, and 72 hour after administration. Folinic acid doses should be given according to the level of HDMTX.

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