Low dose of carglumic acid for treatment of hyperammonemia due to N-acetylglutamate synthase deficiency.

Nutritional deficiency of folate and its further depletion with chemotherapy is common in children with ALL, especially in countries with high prevalence of malnutrition and lack of folate fortification [2]. Despite a documented higher infection-related deaths during induction, and interruption of maintenance chemotherapy in folate deficient children, the theoretical concern of increased relapse has prevented us from supplementing with folic acid. Developed countries with mandatory folate fortification have not encountered increased relapses in the post-fortification era; this is further supported by data from adults where routine folate use during chemotherapy helps in improving the chemotherapy tolerance without compromising efficacy [3].