Accumulation of methotrexate and methotrexate polyglutamates in lymphoblasts and treatment outcome in children with B-progenitor-cell acute lymphoblastic leukemia: a Pediatric Oncology Group study. Leukemia 2005 Apr;19(4):533-6
Date
02/18/2005Pubmed ID
15716987DOI
10.1038/sj.leu.2403703Scopus ID
2-s2.0-20244362526 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
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.
Author List
Whitehead VM, Shuster JJ, Vuchich MJ, Mahoney DH Jr, Lauer SJ, Payment C, Koch PA, Cooley LD, Look AT, Pullen DJ, Camitta BMESH terms used to index this publication - Major topics in bold
Antimetabolites, AntineoplasticB-Lymphocytes
Child
Child, Preschool
Female
Follow-Up Studies
Hematopoietic Stem Cells
Humans
Male
Methotrexate
Polyglutamic Acid
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Survival Rate
Treatment Outcome