Abstract |
We reported that children with B-progenitor-cell acute lymphoblastic leukemia (BpALL) treated in the early 1980s whose lymphoblasts accumulated high levels of methotrexate (MTX) and of methotrexate polyglutamates (MTXPGs) in vitro had an improved 5-year event-free survival (EFS) (65% (standard error (s.e.) 12%) vs 22% (s.e. 9%)). We repeated this study in children with BpALL treated in the early 1990s. The major change in treatment was the addition of 12 24-h infusions of 1 g/M2 MTX with leucovorin rescue (IDMTX). In 87 children treated on Pediatric Oncology Group (POG) study 9005 and POG 9006, the 5-year EFS for those whose lymphoblasts accumulated high levels of MTX and MTXPGs (79.2%, s.e. 8.3%) was not significantly different from that of patients with lesser accumulation of MTX and MTXPGs (77.7%, s.e. 5.4%). These findings support the notion that higher dose MTX therapy has contributed to increased cure, particularly for patients whose lymphoblasts accumulate the drug less well.
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Authors | V M Whitehead, J J Shuster, M J Vuchich, D H Mahoney Jr, S J Lauer, C Payment, P A Koch, L D Cooley, A T Look, D J Pullen, B Camitta |
Journal | Leukemia
(Leukemia)
Vol. 19
Issue 4
Pg. 533-6
(Apr 2005)
ISSN: 0887-6924 [Print] England |
PMID | 15716987
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antimetabolites, Antineoplastic
- Polyglutamic Acid
- methotrexate polyglutamate
- Methotrexate
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Topics |
- Antimetabolites, Antineoplastic
(administration & dosage, pharmacokinetics, therapeutic use)
- B-Lymphocytes
(pathology)
- Child
- Child, Preschool
- Female
- Follow-Up Studies
- Hematopoietic Stem Cells
(pathology)
- Humans
- Male
- Methotrexate
(administration & dosage, analogs & derivatives, pharmacokinetics, therapeutic use)
- Polyglutamic Acid
(administration & dosage, analogs & derivatives, pharmacokinetics)
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy, mortality)
- Survival Rate
- Treatment Outcome
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