Strategies for Assessing Physical Compatibility of Calcium Folinate with Bicarbonate During Methotrexate Rescue Therapy in Pediatric Patients with Acute Lymphoblastic Leukemia.

ABSTRACT: Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most prevalent childhood cancer requiring cytotoxic methotrexate treatment. This always necessitates intravenous administration of rescue therapy consisting of calcium folinate and bicarbonate. Current recommendations advise against mixing these two drugs due to concerns regarding precipitate formation of calcium carbonate (CaCO₃) that could result in catheter and capillary obstruction. These recommendations are based on drug concentrations not clinically relevant in pediatric ALL settings. Our study investigated the effect of clinically relevant calcium folinate-bicarbonate concentrations on the risk of CaCO₃ precipitation. Methods: A theoretical prediction model provided estimates of fina

SUBMITTER: Teimori K 

PROVIDER: S-EPMC12472967 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature