Collaborative Exchange: Leucovorin and Glucarpidase

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The panel discussed the rationale behind the continued use of leucovorin in conjunction with glucarpidase.

Dr. Campen: We continue with leucovorin to provide a full basis for recovery of the cells. One important thing to know is that leucovorin should be given separately from glucarpidase because they do compete when given together.

Dr. Schwartzberg: If you continue to give leucovorin, could you abrogate the benefit, because it is a direct competitor for the enzyme?

Dr. Campen: We administer the leucovorin doses well before the glucarpidase and then continue every 6 hours afterward. It does drop the plasma levels of methotrexate significantly in most patients, but it is necessary to continue leucovorin to combat intracellular methotrexate levels.




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