Are there other need as effective for treating lgl leukemia as methotrexate that aren't as hard on kidneys.

See below: You need treatment for leukemia- your cancer doctor will try their best to ensure that kidneys are ok.

Obesrvation or Tx: Large granular lymphocyte (lgl) leukemia (t-cell or nk-cell) may be observed until there are symptoms due to -- anemia (low hgb), neutropenia (low wbc, anc), thrombocytopenia (low platelets). Treatment may be with methotrexate, cyclosporine, cyclophosphamide, steroids. These drugs all may have associated side effects and should be monitored.