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Common manifestations in children include abdominal bloating and pain, chronic diarrhoea, constipation, failure to thrive, fatigue, gas, headaches, and irritability

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These are less common side effects of pemetrexed therapy (occurring in roughly 10-29 percent of patients): Appetite problems

The PG-DTR group exhibited higher levels of hemoglobin, albumin, and prognostic nutritional index than the TG group throughout the study period, with hemoglobin being the only parameter that was significantly different in both groups in linear mixed model analysis (p=0.007) (Fig