Document Type : Original Article
Authors
1
Medical Pharmacology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
2
Pharmacology & Toxicology Department, Faculty of Pharmacy, Sphinx University, New Assiut City, Assiut, Egypt
3
Cancer Biology Department, Pharmacology and Experimental Oncology Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
4
Department of Pediatric Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
Abstract
Background: the Primary medication used in acute lymphoblastic leukemia is
methotrexate, and the problem with this treatment is that it is hazardous to cancer
patients. The study aim was evaluation of vitamin D effect on methotrexate toxicity,
including oral ulcerations, bone marrow, renal, and hepatic toxicity, besides
inflammatory mediators; IL-6 and TNF-α role in this toxicity. Methods: Methotrexate
was used to treat 58 patients with acute lymphoblastic leukemia in a clinical trial which
was a double-blinded randomized study; (30 in Group A - no vitamin D for 2 weeks
after methotrexate treatment) and (28 in Group B - patient received vitamin D3 drops
for 2 weeks after methotrexate treatment). Results: Leukocytic count, Hemoglobin and
platelet count were significantly lower in patients didn’t receive Vitamin D compared
to patients received Vitamin D. Serum bilirubin, liver enzymes, urea, creatinine, IL-6
and TNF-α levels were significantly higher in patients didn’t receive vitamin D
compared to the other group, while there is no significant change in levels of albumin
and total proteins in both groups. 24 hours after 2nd cycle of methotrexate, the study
group's methotrexate level significantly decreased, while it significantly elevated in the
control group. Mild oral mucositis grade (I, II) showed a significant increase in the
study group and a decrease in the control group, whereas severe oral mucositis grade
(III, IV) showed a significant decrease in the study group and an increase in the control
one. Conclusion: Medication with vitamin D may be a significant factor in reducing
methotrexate toxicity.
Keywords
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