High-dose Methotrexate vs. Capizzi Methotrexate for the Treatment of Childhood T-cell Acute Lymphoblastic Leukemia

Publication date: Available online 9 October 2018Source: Leukemia Research ReportsAuthor(s): Wasil JastaniahAbstractSixty-three children (1 – 14 years of age) newly diagnosed with T-cell acute lymphoblastic leukemia were treated from January 2001 to December 2014. Patient outcomes were evaluated based on the regimen received; Capizzi methotrexate (C-MTX) vs. high-dose methotrexate (HDMTX). Complete remission (CR) was achieved in 54 of 60 (90.0%) patients and 3 patients died during induction. The 5-year overall survival (OS) and disease-free survival (DFS) were 88.3±6.5% and 85±7.5%, respectively. Post-induction, 35 patients were treated with HDMTX and 25 with C-MTX. There was no difference in OS or DFS for patients treated with HDMTX vs. C-MTX (P>0.05 for both). Central nervous system involvement (CNS3) was associated with inferior survival outcomes compared to Non-CNS3 patients (OS, CNS3 73.3±9.1% vs.non-CNS3 93.2±2.6%, (P=0.045) and DFS, CNS3 66.7±10.4% vs. non-CNS3 90.9±3.1% (P=0.0163)). Delayed radiation in CNS3 was associated with relapse (P=0.0037) regardless of regimen. Thus optimization of CNS-directed therapy for patients with CNS3 is needed.
Source: Leukemia Research Reports - Category: Hematology Source Type: research