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Dose Intensification of Methotrexate and Cytarabine During Intensified Continuation Chemotherapy for High-risk B-Precursor Acute Lymphoblastic Leukemia
| Content Provider | Scilit |
|---|---|
| Author | Tower, Richard L. Jones, Tamekia L. Camitta, Bruce M. Asselin, Barbara L. Bell, Beverly A. Chauvenet, Allen Devidas, Meenakshi Halperin, Edward C. Pullen, Jeanette Shuster, Jonathan J. Winick, Naomi Kurtzberg, Joanne |
| Copyright Year | 2014 |
| Description | Journal: Journal of pediatric hematology/oncology Purpose: To determine the efficacy and toxicity of higher dose versus standard dose intravenous methotrexate (MTX) and pulses of high-dose cytosine arabinoside with asparaginase versus standard dose cytosine arabinoside and teniposide during intensified continuation therapy for higher risk pediatric B-precursor acute lymphoblastic leukemia (ALL). Patients and Methods: From 1994 to 1999, the Pediatric Oncology Group conducted a randomized phase III clinical trial in higher risk pediatric B-precursor ALL. A total of 784 patients were randomized in a 2×2 factorial design to receive MTX 1 g/m2 versus 2.5 g/m2 and to cytosine arabinoside/teniposide versus high-dose cytosine arabinoside/asparaginase during intensified continuation therapy. Results: Patients receiving standard dose MTX had a 5-year disease-free survival (DFS) of 71.8±2.4%; patients receiving higher dose MTX had a 5-year DFS of 71.7±2.4% (P=0.55). Outcomes on cytosine arabinoside/teniposide (DFS of 70.4±2.4) were similar to higher dose cytosine arabinoside/asparaginase (DFS of 73.1±2.3%) (P=0.41). Overall survival rates were not different between MTX doses or cytosine arabinoside/teniposide versus cytosine arabinoside/asparaginase. Conclusions: Increasing MTX dosing to 2.5 g/m2 did not improve outcomes in higher risk pediatric B-precursor ALL. Giving high-dose cytarabine and asparaginase pulses instead of standard dose cytarabine and teniposide produced nonsignificant differences in outcomes, allowing for teniposide to be removed from ALL therapy. |
| Related Links | http://europepmc.org/articles/pmc4120865?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120865/pdf |
| Ending Page | 361 |
| Page Count | 9 |
| Starting Page | 353 |
| ISSN | 10774114 |
| e-ISSN | 15363678 |
| DOI | 10.1097/mph.0000000000000131 |
| Journal | Journal of pediatric hematology/oncology |
| Issue Number | 5 |
| Volume Number | 36 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2014-07-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of pediatric hematology/oncology Acute Lymphoblastic Leukemia |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hematology Pediatrics, Perinatology and Child Health Oncology |
