Skip to main content

Prognostic Significance of Exposure to Intermediate-Dose Methotrexate in Children with Standard Risk ALL: The COALL 82/85 Experience

  • Conference paper
Acute Leukemias

Abstract

Methotrexate is being widely used in doses ranging from 500 to 2 000 mg administered as prolonged infusion over 12–36 h followed by leucovorin rescue to consolidate remission of acute lymphoblastic leukemia [1–4]. There is evidence that prolonged duration of exposure to methotrexate has a positive impact on the length of remission of ALL. Patients with a rapid systemic clearance of methotrexate have a higher risk of relapse [5–7].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Freeman AI, Brecher ML, Wang JJ, Sinks LF (1979) Intermediate dose methotrexate (IDM) in childhood acute lymphocytic leukemia (ALL). Hämatol Bluttransfus 23: 115–123

    Article  CAS  Google Scholar 

  2. Moe PJ, Seip M, Finne PH (1981) Intermediate dose methotrexate (IDM) in childhood acute lymphocytic leukemia in Norway. Preliminary results of a national treatment program. Acta Paediatr Scand 70: 73–79

    Article  PubMed  CAS  Google Scholar 

  3. Janka GE, Mack R, Helmig M, Haas R, Bidlingmaier F (1984) Prolonged methotrexate infusions in children with acute leukemia in relapse and in remission and with medulloblastoma. Pharmacokinetics, toxicity and clinical results. Oncology 41: 225–232

    Article  PubMed  CAS  Google Scholar 

  4. Jürgens H (1983) Hochdosierte Methotrexatbehandlung. Indikation, Risiken, Steuerung. Urban and Schwarzenberg, Munich

    Google Scholar 

  5. Evans WE, Stewart CF, Chen CH et al. (1984) Methotrexate systemic clearance influences probability of relapse in children with standard risk acute lymphoblastic leukemia. Lancet ß: 359–362

    Google Scholar 

  6. Borsi JD, Moe PJ (1987) Systemic clearance of methotrexate in the prognosis of acute lymphoblastic leukemia in children. Cancer 60: 3020–3024

    Article  PubMed  CAS  Google Scholar 

  7. Borsi JD, Moe PJ (1990) Pharmacokinetics of methotrexate and folinic acid in children: an update. In: Borsi JP, Riccardi R (eds.) Role of clinical pharmacology in pediatric oncology. Workshop Proceedings, Rome

    Google Scholar 

  8. Janka GE, Winkler K, Jürgens H, Göbel U, Gutjahr P, Spaar HJ (1986) Akute lymphoblastische Leukämie im Kindesalter: Die COALL-Studien. Khn Pädiatr 198: 171–177

    Article  CAS  Google Scholar 

  9. Janka-Schaub GE, Winkler K, Jürgens H, Göbel U, Gutjahr P, Spaar HJ (1986) Intermediate-dose methotrexate in the treatment of childhood acute lymphocytic leukemia: lack of benefit during maintenance therapy following intensive induction therapy. Eur J Pediatr 145: 14–17

    Article  PubMed  CAS  Google Scholar 

  10. Bleyer WA (1989) New vistas for leucovorin in cancer chemotherapy. Cancer 63: 995–1007

    Article  PubMed  CAS  Google Scholar 

  11. Borsi JD, Sagen E, Romslo I, Moe PJ (1990) Rescue after intermediate and high-dose methotrexate: background, rationale, and current practice. Pediatr Hematol Oncol 7: 347–363

    Article  PubMed  CAS  Google Scholar 

  12. Bleyer WA (1978) The clinical pharmacology of methotrexate. New applications of an old drug. Cancer 41: 36–51

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Jürgens, H., Janka, G., Ibrahim, M., Tonert, C., Winkler, K., Göbel, U. (1992). Prognostic Significance of Exposure to Intermediate-Dose Methotrexate in Children with Standard Risk ALL: The COALL 82/85 Experience. In: Hiddemann, W., Büchner, T., Wörmann, B., Plunkett, W., Keating, M., Andreeff, M. (eds) Acute Leukemias. Haematology and Blood Transfusion / Hämatologie und Bluttransfusion, vol 34. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76591-9_54

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-76591-9_54

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-53949-0

  • Online ISBN: 978-3-642-76591-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics