RFC Confounding Issues

In addition to the frequent concerns of sample size and MTX dosing, clinical variation in the use of leucovorin may also confound these analyses. Furthermore, the Shimaski et al. study may be subject to treatment period effects as anti-emetic practices change over treatment eras (12). As noted by Laverdiere, prospective studies evaluating multiple fo-late pathway polymorphisms will be necessary to define clearly the relationship between the RFC G80A polymorphism and ALL treatment response (24).

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