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Leuk Lymphoma. 2019 May 23:1-4. doi: 10.1080/10428194.2019.1612061. [Epub ahead of print]

Effect of leucovorin administration on mucositis and skin reactions in patients with peripheral T-cell lymphoma or cutaneous T-cell lymphoma treated with pralatrexate.

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a Department of Hematology , School of Medicine, Yale University , New Haven , CT , USA.
b Department of Dermatology , School of Medicine, Yale University , New Haven , CT , USA.
c School of Medicine, Yale University , New Haven , CT , USA.


Peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) are rare, heterogeneous non-Hodgkin lymphomas with poor prognoses. Pralatrexate has demonstrated efficacy in T-cell lymphomas; however, mucositis has been reported as the most common dose-modifying adverse event. Leucovorin has been shown to minimize mucositis incidence, without sacrificing pralatrexate efficacy. We retrospectively studied 34 patients (7-PTCL/27-CTCL) treated with pralatrexate alone or pralatrexate and leucovorin. Leucovorin was administered preemptively prior to any mucositis occurrence. Pralatrexate dosing ranged from 10-30 mg/m2 and clinical response or disease stabilization was observed in 85.2%. The incidence of mucositis was reduced in CTCL patients to 17% and was ameliorated in all but one patient with PTCL. There was no change the incidence of skin reactions with the addition of leucovorin. The response rates were similar to those previously reported in CTCL and PTCL. The addition of leucovorin reduced the incidence of mucositis in patients with CTCL and PTCL.


Mucositis; cutaneous T-cell lymphoma; leucovorin; peripheral T-cell lymphoma; pralatrexate; skin reactions

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