Randomized comparison of moderate-dose methotrexate infusions to oral methotrexate in children with intermediate risk acute lymphoblastic leukemia: a Childrens Cancer Group study

Medical and Pediatric Oncology
B J LangeA T Meadows

Abstract

Methotrexate (MTX) infusions of 500--1,000 mg/m2 over 24 hours may improve survival and prevent relapse in children with acute lymphoblastic leukemia (ALL). Childrens Cancer Group (CCG) Study 139 compared weekly oral methotrexate 20 mg/m2/week (oral MTX) to MTX 500 mg/m2 infused over 24 hours (IV MTX) three times during consolidation and every 6 weeks during maintenance in 164 children with intermediate-risk ALL, i.e., those patients over age 1 year with white blood cell count 10,000 to 49,999/ml and no bulky extramedullary disease. Median follow-up for CCG-139 exceeded 75 months. Thirty-four events occurred among 80 patients receiving IV and oral MTX and 36 events among 84 patients receiving oral MTX. Two children died during induction and one did not enter remission. Remission induction rate is 98%. There have been 26 marrow relapses, 11 combined marrow and extramedullary relapses, 24 CNS relapses, and five testicular or other relapses. The frequency and distribution of relapses does not differ between the two regimens. For the entire group, overall event-free survival (EFS) at 6 years is 57.9% (standard deviation=4.0%) and actuarial survival is 80.0% (standard deviation =3.3%). Of the 29 patients with isolated extramedullary...Continue Reading

References

Jan 1, 1977·British Journal of Haematology·J Palek
Oct 1, 1989·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·B CamittaL Munoz
Nov 3, 1983·The New England Journal of Medicine·J JolivetB A Chabner
May 1, 1983·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M E NesbitG D Hammond
Dec 1, 1983·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·L S FrankelJ Pullen
Mar 1, 1993·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·D G TubergenG D Hammond

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Citations

Dec 29, 2000·Pediatric Hematology and Oncology·P D Cole, B A Kamen
Jun 24, 2008·Leukemia & Lymphoma·Michael E TriggUNKNOWN Children's Oncology Group
Jun 14, 2012·Pediatric Blood & Cancer·Sue RichardsUNKNOWN Childhood Acute Lymphoblastic Leukemia Collaborative Group (CALLCG)
Oct 23, 1997·Journal of the National Cancer Institute·M A SmithR Simon
May 2, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M ClarkeUNKNOWN Childhood ALL Collaborative Group
Jul 12, 2005·Pediatric Blood & Cancer·Stuart S WinterMichael D Amylon
Oct 19, 2000·Journal of Pediatric Hematology/oncology·P S Gaynon
Jul 26, 2002·British Journal of Haematology·Judith M ChessellsUNKNOWN Medical Research Council Working Party On Childhood Leukaemia
Mar 1, 1997·Pediatric Hematology and Oncology·A T Meadows, G J D'Angio

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