J N Van der Beek1, N Oosterom2, R Pieters1, R de Jonge3, M M van den Heuvel-Eibrink1, S G Heil4. 1. Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. 2. Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, the Netherlands. 3. Department of Clinical Chemistry, VU Medical Center, Amsterdam, the Netherlands; Department of Clinical Chemistry, Amsterdam Medical Center, Amsterdam, the Netherlands. 4. Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, the Netherlands. Electronic address: s.heil@erasmusmc.nl.
Abstract
INTRODUCTION: This study aimed to determine the efficacy of different Leucovorin regimens to reduce oral mucositis in children with acute lymphoblastic leukemia after high-dose Methotrexate (HD-MTX). METHODS: Twelve articles were included in a systematic literature review. Articles were categorized into low/medium/high risk of bias. RESULTS: As no randomized controlled trial assessing the effect of Leucovorin has been performed, the efficacy of Leucovorin to reduce oral mucositis remains unknown. Leucovorin was initiated at 24, 36 or 42 h after HD-MTX at a dose of 15 or 30 mg/m2. No meta-analysis could be performed as treatment regimens differed. When comparing studies with similar HD-MTX doses, we observed lower oral mucositis rates in regimens with higher cumulative doses of Leucovorin and early initiation of Leucovorin after MTX. CONCLUSION: Even though future studies are necessary, higher cumulative Leucovorin doses and early initiation of Leucovorin after start of MTX seem to reduce oral mucositis.
INTRODUCTION: This study aimed to determine the efficacy of different Leucovorin regimens to reduce oral mucositis in children with acute lymphoblastic leukemia after high-dose Methotrexate (HD-MTX). METHODS: Twelve articles were included in a systematic literature review. Articles were categorized into low/medium/high risk of bias. RESULTS: As no randomized controlled trial assessing the effect of Leucovorin has been performed, the efficacy of Leucovorin to reduce oral mucositis remains unknown. Leucovorin was initiated at 24, 36 or 42 h after HD-MTX at a dose of 15 or 30 mg/m2. No meta-analysis could be performed as treatment regimens differed. When comparing studies with similar HD-MTX doses, we observed lower oral mucositis rates in regimens with higher cumulative doses of Leucovorin and early initiation of Leucovorin after MTX. CONCLUSION: Even though future studies are necessary, higher cumulative Leucovorin doses and early initiation of Leucovorin after start of MTX seem to reduce oral mucositis.
Authors: E Driehuis; N Oosterom; S G Heil; I B Muller; M Lin; S Kolders; G Jansen; R de Jonge; R Pieters; H Clevers; M M van den Heuvel-Eibrink Journal: PLoS One Date: 2020-05-18 Impact factor: 3.240
Authors: Giuseppina Ioele; Martina Chieffallo; Maria Antonietta Occhiuzzi; Michele De Luca; Antonio Garofalo; Gaetano Ragno; Fedora Grande Journal: Molecules Date: 2022-08-25 Impact factor: 4.927
Authors: N Oosterom; M Fiocco; R Q H Kloos; I M van der Sluis; R Pieters; B D van Zelst; D E C Smith; M M van den Heuvel-Eibrink; R de Jonge; S G Heil Journal: BMC Cancer Date: 2020-09-30 Impact factor: 4.430