High‐dose methotrexate for the remission induction of refractory adult acute lymphocytic leukemia

Peterson, Bruce A.; Bloomfield, Clara D.

doi:10.1002/mpo.2950050112

Cited by 13 publications

(1 citation statement)

References 13 publications

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“…This was an attempt at early consolidation. There was no morbidity immediately associated with this treatment, which suggests that a higher dose (Peterson & Bloomfield. 1978;Medical Research Council UKALL Trials, 1986) may be effective in consoiidation in this disease.…”

Section: Discussionmentioning

confidence: 85%

Results of Medical Research Council trial UKALL IX in acute lymphoblastic leukaemia in adults: report from the Medical Research Council Working Party on Adult Leukaemia

Durrant

Richards

1993

Br J Haematol

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The MRC UKALL IX trial for patients with untreated ALL aged 14 years and over was open to new patients from July 1980 to April 1985. 266 patients were randomized between two induction schedules. M (involving intermediate dose methotrexate with folinic acid rescue) and D (involving daunorubicin). Schedule M resembled that used in the previous MRC adult ALL trial (UKALL VI), while schedule D was somewhat more intensive. No difference in disease-free survival was found between the treatment arms, but patients on the daunorubicin arm went into remission earlier. The overall remission rate was 87%, which is at least as good as in contemporary studies elsewhere; factors predictive of a lower remission rate were older age and higher WBC. For those who entered remission. WBC, age and sex were the most important prognostic factors. Time to achieve remission was not a significant factor after allowance was made for these. An historical comparison does not show any improvement over the preceding MRC adult trial, although the subsequent trial does show a modest improvement at present. Because the improved outlook seen in children is not apparent in adults, and no other randomized trial has demonstrated substantial benefit for any particular regimen, the next trial, UKALL XII, will be investigating the benefit or otherwise of bone marrow transplantation.

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Section: Discussionmentioning

confidence: 85%

Results of Medical Research Council trial UKALL IX in acute lymphoblastic leukaemia in adults: report from the Medical Research Council Working Party on Adult Leukaemia

Durrant

Richards

1993

Br J Haematol

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Primary refractory and relapsed adult acute lymphoblastic leukemia

Thomas

Kantarjian

Smith

et al. 1999

Cancer

175

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Adult acute leukemia. Aggressive treatment improves survival

Eyre¹,

Ward²,

Priebat³

1983

Cancer

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Although improvements in the management of adults with acute leukemia have lagged behind those seen in the treatment of children, there are clear reasons for optimism. Combination chemotherapy for acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL) in adults results in complete remissions in 50–85% of patients. An increasing number of these patients remain in continuous remission for over two years with a significant proportion (15–25%) disease‐free after five years. Those who remain in remission for more than five years have a low incidence of relapse and many may be cured. Nevertheless, there are still many problems to be solved. Improved, less toxic induction regimens are needed. The roles of maintenance, late intensification, and central nervous system prophylaxis remain unresolved. The results of bone marrow transplantation for adults with AML in remission are encouraging enough to make this an attractive form of therapy for any patient younger than age 40 with a histocompatible sibling. New forms of treatment, such as immunotherapy and monoclonal antibodies, remain investigational.

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High‐dose methotrexate for the remission induction of refractory adult acute lymphocytic leukemia

Cited by 13 publications

References 13 publications

Results of Medical Research Council trial UKALL IX in acute lymphoblastic leukaemia in adults: report from the Medical Research Council Working Party on Adult Leukaemia

Results of Medical Research Council trial UKALL IX in acute lymphoblastic leukaemia in adults: report from the Medical Research Council Working Party on Adult Leukaemia

Primary refractory and relapsed adult acute lymphoblastic leukemia

Adult acute leukemia. Aggressive treatment improves survival

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