Systemic effect of intrathecal methotrexate during the initial phase of treatment of childhood acute lymphoblastic leukemia. The European Organization for Research and Treatment of Cancer Children's Leukemia Cooperative Group

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
A ThyssJacques Otten

Abstract

The in vivo response to prephase corticosteroid therapy for 1 week has been described as a major prognostic factor in childhood acute lymphoblastic leukemia (ALL). Patients with less than 1,000 blasts/microL at day 8 are considered responders and have a better prognosis. This prephase therapy is usually considered as an evaluation of glucocorticoid sensitivity. In fact, it also includes one intrathecal (IT) injection of methotrexate (MTX). In this study, we try to clarify the influence of this injection of IT MTX on the response to the prephase therapy. This retrospective study analyzed the response to prephase therapy in 1,044 children with ALL entered onto the European Organization for Research and Treatment of Cancer (EORTC) trial 58881 of the Children's Leukemia Cooperative Group (CLCG). Analysis was restricted to 732 cases with an initial blast count greater than 1,000/microL. The following variables were tested to analyze response to prephase therapy: age, sex, evaluated risk factor (RF), blast count on day 0, actual dose of prednisolone administered, immunophenotype (T v non-T), and day of IT MTX. For statistical analysis, the variable day of IT MTX (D) was stratified into three groups: group 1 if D less than 2, group 2 ...Continue Reading

Citations

Mar 7, 2002·Journal of Pediatric Hematology/oncology·C H Pui
Nov 26, 1999·Pediatric Dermatology·F MillotF Guilhot
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Sep 9, 2008·Journal of Pediatric Hematology/oncology·Maria Teresa Amparo BuendiaGonzalo Guevara
Jun 13, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Yiwei LiuMary V Relling
May 14, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Hsi-Che LiuDer-Cherng Liang

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