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Before receiving folic acid or cyanocobalamin, patients should be assessed for deficiency and appropriate therapy started concurrently

Crider KS, Qi YP, Yeung LF, Mai CT, Zauche LH, Wang A, et al

Methods Patient selection The inclusion criteria for the patients were as follows: patients 1) with histologically or cytologically proven non-Sq NSCLC and MPM, 2) planning to use pemetrexed-containing chemotherapy, 3) nave or previously treated with chemotherapy, 4) with ECOG-PS of 02, 5) age 20 years, 6) with adequate organ function measured as leukocyte count 3,000 /L, hemoglobin concentration 10.0 g/dL, platelet count 100,000 /L, total bilirubin level 2.0 mg/dL, transaminase levels 100 IU/L, serum creatinine level 1.5 mg/dL, SpO 2 (percutaneous oxygen saturation) 90% in ambient air, 7) expected to survive at least 12 weeks from the start of treatment, and 8) who provided written informed consent

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As levels rise, these symptoms can improve within a few days or weeks