Evidence supporting the use of: Leucovorin
For the health condition: Leukemia

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Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Leucovorin, also known as folinic acid, is scientifically validated for use in the treatment and support of leukemia, particularly in conjunction with methotrexate therapy. Methotrexate is a chemotherapeutic agent widely used in various leukemias, including acute lymphoblastic leukemia (ALL). Methotrexate works as an antifolate, inhibiting dihydrofolate reductase and thus interfering with DNA synthesis, repair, and cellular replication. However, high doses of methotrexate can cause significant toxicity to normal cells, especially in the bone marrow and gastrointestinal tract.

Leucovorin is administered as "leucovorin rescue" after methotrexate treatment. It does not counteract the anticancer effects of methotrexate in malignant cells but supplies reduced folate to healthy cells, thereby allowing them to bypass the metabolic block induced by methotrexate. This significantly reduces the risk of life-threatening toxicity without compromising the effectiveness of the chemotherapy. The timing and dosing of leucovorin rescue are critical and based on methotrexate plasma levels to maximize protective effects while maintaining anticancer activity.

This practice is supported by numerous clinical trials and decades of standard oncological protocols. Guidelines from major hematology and oncology societies endorse its use as an evidence-based standard of care in high-dose methotrexate regimens for leukemia. Thus, the scientific rationale and clinical data supporting leucovorin’s use in leukemia are robust and well-established.

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