The effectiveness of L-Carnitine in improving liver enzymes in Leukemic patients treated with Methotrexate and 6-Mercaptopurine

Introduction: One of the side effects of Methotrexate and 6-Mercaptopurine used in the treatment of patients with Acute Lymphoblastic Leukemia (ALL) is drug hepatitis and increase in the level of liver enzymes. The aim of this study was to determine the effectiveness of L-Carnitine in improving liver enzymes in patients treated with methotrexate and 6-Mercaptopurine. Methods: This study was conducted as a single-blind randomized clinical trial (RCT) in the pediatric oncology department of Mohammad Kermanshahi Hospital, Kermanshah, Iran. The present study was performed on 26 patients with ALL treated with methotrexate and 6-mercaptopurine who their liver enzymes were between two to four times normal levels. Patients were randomly assigned into two groups including the L-carnitine receiving group and the placebo receiving group. Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) levels, and L-carnitine side effects including headache, vomiting, and diarrhea were assessed up to 3 months, once every two weeks. To analyze the data, SPSS 16 was used and significant level was considered at < 0.05. Results: There were no statistically significant differences between control and intervention groups in terms of side effects of L-carnitine including diarrhea, vomiting and headache (P-value> 0.05). In first four visits, no statistically significant difference was observed in level of liver enzymes in the two groups (P-value> 0.05). However, in the fifth and sixth evaluations, a statistically significant difference was seen at the level of liver enzymes between the two groups of intervention and control (P-value <0.05). Conclusion: Based on the results of this study, it seems that L-carnitine in patients treated with methotrexate and 6-mercaptopurine is effective in improving the level of liver enzymes.