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

Lange, Beverly J.; Blatt, Julie; Sather, Harland N.; Meadows, Anna T.

doi:10.1002/(sici)1096-911x(199607)27:1<15::aid-mpo4>3.0.co;2-x

Cited by 23 publications

(9 citation statements)

References 26 publications

(1 reference statement)

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“…It is disappointing that, although the dosage of MTX used in UKALL XI (6-8 g/m 2 ) was higher than that used in previously reported trials, it did not produce a significant benefit in EFS. Some earlier randomized trials of moderate dose MTX infusions (0AE5-1AE0 g/m 2 ) had shown apparently reduced relapse rates (Pui et al, 1992;Freeman et al, 1997), while another trial (Lange et al, 1996) did not.…”

Section: Discussionmentioning

confidence: 95%

Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk‐stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172)

Hill

Richards²,

Gibson

et al. 2003

Br J Haematol

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SummaryConcern about late adverse effects of cranial radiotherapy (XRT) has led to alternative approaches to eliminate leukaemia from the central nervous system (CNS) in childhood acute lymphoblastic leukaemia (ALL). The Medical Research Council UKALL XI trial recruited 2090 children with ALL between 1990 and 1997. Median follow-up is 7 years 9 months; event-free survival (EFS) and overall survival were 63AE1% and 84AE6%, respectively, at 5 years and 59AE8% and 79AE4% at 10 years. The isolated CNS relapse rate was 7AE0% at 10 years. Patients were randomized for CNS-directed therapy within white blood cell (WBC) groups. For WBC <50 · 10 9 /l, high-dose intravenous methotrexate (HDMTX) (6-8 g/m 2 ) with intrathecal methotrexate (ITMTX) was compared with ITMTX alone, and was significantly better at preventing isolated and combined CNS relapse, but non-CNS relapses were similar. There was no significant difference in EFS at 10 years, 64AE1% [95% confidence interval (CI) 60AE4-67AE8] with HDMTX plus ITMTX, and 63AE0% (95% CI 59AE5-66AE5) with ITMTX alone. For WBC ‡50 · 10 9 /l, HDMTX with ITMTX was compared with XRT and a short course of ITMTX. CNS relapses were significantly fewer with XRT, but there was a non-significant increase in non-CNS relapses. EFS was not significantly different, being 55AE2% (95% CI 47AE8-62AE6) at 10 years with XRT and 52AE1% (95% CI 44AE8-59AE4) with HDMTX plus ITMTX.

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Section: Discussionmentioning

confidence: 95%

Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk‐stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172)

Hill

Richards²,

Gibson

et al. 2003

Br J Haematol

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“…The eligibility criteria, treatment regimens, and results of these trials have been reported and summarized elsewhere. 5,[16][17][18][19][20][21][22][23][24][25][26] In general, patients were required to be younger than 21 years of age at diagnosis and to have previously untreated ALL, defined by conventional criteria. Informed consent was obtained from each patient or guardian according to institutional policy following approval of the studies by the local institutional review boards.…”

Section: Patients Materials and Methodsmentioning

confidence: 95%

Clinical characteristics and outcome of children with Down syndrome and acute lymphoblastic leukemia: a Children's Cancer Group study

Whitlock

Sather

Gaynon

et al. 2005

Blood

121

144

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We assessed the outcome of children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) receiving contemporary risk-based therapy by evaluating clinical and biologic features and outcome of children with ALL, with or without DS, enrolled in Children's Cancer Group (CCG) protocols between 1983 and 1995. Comparison of characteristics of children with ALL with (ALL-DS; n ‫؍‬ 179) or without (ALL-NDS; n ‫؍‬ 8268) DS showed no differences in initial white blood cell (WBC) count, central nervous system disease, and risk group. Children with ALL-DS did not present with unfavorable translocations and were older than 1 year of age at diagnosis with ALL. Eventfree (56% vs 74%; P < .001) and diseasefree (55% vs 73%; P < .001) survival at 10 years was significantly lower in the standard-risk ALL-DS population compared with ALL-NDS, but not in high-risk ALL-DS population (event-free survival, 62% vs 59%; P ‫؍‬ .9; disease-free survival, 64% vs 59%; P ‫؍‬ .9), and these differences persisted regardless of treatment era (early era [1983][1984][1985][1986][1987][1988][1989] vs recent era [1989][1990][1991][1992][1993][1994][1995]

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“…[7][8][9][10][11] The CCG conducted a trial (CCG-1882) for high-risk patients with slow early response using an augmented BFM backbone. This regimen used escalating intermediate-dose IV MTX without leucovorin rescue and additional doses of vincristine and asparaginase during the 2 IM phases of therapy.…”

Section: Introductionmentioning

confidence: 99%

Escalating intravenous methotrexate improves event-free survival in children with standard-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group

Matloub

Bostrom

Hunger

et al. 2011

Blood

127

123

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

Cited by 23 publications

References 26 publications

Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk‐stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172)

Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk‐stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172)

Clinical characteristics and outcome of children with Down syndrome and acute lymphoblastic leukemia: a Children's Cancer Group study

Escalating intravenous methotrexate improves event-free survival in children with standard-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group

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