BIOMAT Database Logo BIOMAT Database Logo

Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children. 1983

A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland

We compared two regimens with respect to their ability to prolong disease-free survival in 506 children and adolescents with acute lymphocytic leukemia. All responders to induction therapy were randomized to treatment with 2400 rad of cranial irradiation plus intrathecal methotrexate or to treatment with intermediate-dose methotrexate plus intrathecal methotrexate, as prophylaxis for involvement of the central nervous system and other "sanctuary" areas. Patients were then treated with a standard maintenance regimen. Complete responders were stratified into either standard-risk or increased-risk groups on the basis of age and white-cell count at presentation. Among patients with standard risk, hematologic relapses occurred in 9 of 117 given methotrexate and 24 of 120 given irradiation (P less than 0.01). The rate of central-nervous-system relapse was higher in the methotrexate group (23 of 117) than in the irradiation group (8 of 120) (P = 0.01). Among patients with increased risk, radiation offered greater protection to the central nervous system than methotrexate (P = 0.03); there was no difference in the rate of hematologic relapse. In both risk strata the frequency of testicular relapse was significantly lower in the methotrexate group (1 patient) than the radiation group (10 patients) (P = 0.01). Methotrexate offered better protection against systemic relapse in standard-risk patients and better protection against testicular relapse overall, but it offered less protection against relapses in the central nervous system than cranial irradiation.

UI MeSH Term Description Entries
D007278 Injections, Spinal Introduction of therapeutic agents into the spinal region using a needle and syringe. Injections, Intraspinal,Injections, Intrathecal,Intraspinal Injections,Intrathecal Injections,Spinal Injections,Injection, Intraspinal,Injection, Intrathecal,Injection, Spinal,Intraspinal Injection,Intrathecal Injection,Spinal Injection
D007945 Leukemia, Lymphoid Leukemia associated with HYPERPLASIA of the lymphoid tissues and increased numbers of circulating malignant LYMPHOCYTES and lymphoblasts. Leukemia, Lymphocytic,Lymphocytic Leukemia,Lymphoid Leukemia,Leukemias, Lymphocytic,Leukemias, Lymphoid,Lymphocytic Leukemias,Lymphoid Leukemias
D008297 Male Males
D008727 Methotrexate An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of TETRAHYDROFOLATE DEHYDROGENASE and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. Amethopterin,Methotrexate Hydrate,Methotrexate Sodium,Methotrexate, (D)-Isomer,Methotrexate, (DL)-Isomer,Methotrexate, Dicesium Salt,Methotrexate, Disodium Salt,Methotrexate, Sodium Salt,Mexate,Dicesium Salt Methotrexate,Hydrate, Methotrexate,Sodium, Methotrexate
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D002493 Central Nervous System Diseases Diseases of any component of the brain (including the cerebral hemispheres, diencephalon, brain stem, and cerebellum) or the spinal cord. CNS Disease,Central Nervous System Disease,Central Nervous System Disorder,CNS Diseases,Central Nervous System Disorders
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children

Related Publications

A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Disposition of intermediate-dose methotrexate in children with acute lymphocytic leukemia.
November 1982, Drug intelligence & clinical pharmacy,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
The treatment of primary childhood acute lymphocytic leukemia with intermediate dose methotrexate.
January 1981, Haematology and blood transfusion,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Intermediate dose methotrexate (IDM) in children with acute lymphocytic leukemia (ALL). An update.
January 1985, Sangre,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Preventive cranial irradiation in the treatment of acute lymphocytic leukemia in children.
January 1978, Radiologia clinica,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
[High dose methotrexate in children with acute lymphocytic leukemia].
February 1979, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Intermediate dose methotrexate (IDM) in childhood acute lymphocytic leukemia (ALL).
January 1979, Haematology and blood transfusion,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Intermediate-dose methotrexate versus cranial irradiation in childhood acute lymphoblastic leukemia: a ten-year follow-up.
February 1997, Medical and pediatric oncology,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
High-dose methotrexate for the remission induction of refractory adult acute lymphocytic leukemia.
January 1978, Medical and pediatric oncology,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
High-dose methotrexate in acute lymphocytic leukemia.
July 1977, Cancer treatment reports,
A I Freeman, and V Weinberg, and M L Brecher, and B Jones, and A S Glicksman, and L F Sinks, and M Weil, and H Pleuss, and J Hananian, and E O Burgert, and G S Gilchrist, and T Necheles, and M Harris, and F Kung, and R B Patterson, and H Maurer, and B Leventhal, and L Chevalier, and E Forman, and J F Holland
Post-induction treatment of childhood acute lymphocytic leukemia.
January 1984, The New England journal of medicine,
Copied contents to your clipboard!