METHOTREXATE SYSTEMIC CLEARANCE INFLUENCES PROBABILITY OF RELAPSE IN CHILDREN WITH STANDARD-RISK ACUTE LYMPHOCYTIC LEUKAEMIA

William E. Evans, Clinton F. Stewart, Chen Hsin Chen, William R. Crom, W. Paul Bowman, Minnie Abromowitch, Joseph V. Simone

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Abstract

108 children with standard-risk acute lymphocytic leukaemia (ALL) were randomised to a post-induction treatment protocol including 15 doses of intermediate-dose methotrexate (1000 mg/m2) in addition to conventional oral therapy of mercaptopurine and low-dose methotrexate. After median follow-up of 26 months, 22 patients have had relapses. Among the 108 patients, rates of methotrexate systemic clearance ranged from 44·7 to 132 ml/min/m2. When the group was divided into three subgroups according to the patients' rates of methotrexate clearance, statistical analysis of the Kaplan-Meier curves estimating the probability of complete remission showed significant differences (p=0·016) among the subgroups, patients with faster clearance having higher probability of relapse. Multivariate Cox's regression analysis incorporating other potential prognostic variables identified three significant variables influencing the risk of relapse-methotrexate clearance and white-blood-cell count and haemoglobin level at diagnosis (p=0·0015). This study has demonstrated the potential clinical importance of the rate of drug clearance in children with ALL.

Original languageEnglish (US)
Pages (from-to)359-362
Number of pages4
JournalThe Lancet
Volume323
Issue number8373
DOIs
StatePublished - Feb 18 1984

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Methotrexate
Recurrence
6-Mercaptopurine
Kaplan-Meier Estimate
Clinical Protocols
Leukocyte Count
Hemoglobins
Regression Analysis
Pharmaceutical Preparations
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

METHOTREXATE SYSTEMIC CLEARANCE INFLUENCES PROBABILITY OF RELAPSE IN CHILDREN WITH STANDARD-RISK ACUTE LYMPHOCYTIC LEUKAEMIA. / Evans, William E.; Stewart, Clinton F.; Chen, Chen Hsin; Crom, William R.; Bowman, W. Paul; Abromowitch, Minnie; Simone, Joseph V.

In: The Lancet, Vol. 323, No. 8373, 18.02.1984, p. 359-362.

Research output: Contribution to journalArticle

Evans, William E. ; Stewart, Clinton F. ; Chen, Chen Hsin ; Crom, William R. ; Bowman, W. Paul ; Abromowitch, Minnie ; Simone, Joseph V. / METHOTREXATE SYSTEMIC CLEARANCE INFLUENCES PROBABILITY OF RELAPSE IN CHILDREN WITH STANDARD-RISK ACUTE LYMPHOCYTIC LEUKAEMIA. In: The Lancet. 1984 ; Vol. 323, No. 8373. pp. 359-362.
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