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Blood, 1 March 2008, Vol. 111, No. 5, pp. 2573-2580. Prepublished online as a Blood First Edition Paper on December 18, 2007; DOI 10.1182/blood-2007-07-102525. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-07-102525v1 111/5/2573    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by von Stackelberg, A. Articles by Henze, G. Search for Related Content PubMed PubMed Citation Articles by von Stackelberg, A. Articles by Henze, G. Related Collections Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS High-dose compared with intermediate-dose methotrexate in children with a first relapse of acute lymphoblastic leukemia Arend von Stackelberg1, Reinhard Hartmann1, Christoph Bührer2, Rüdiger Fengler1, Gritta Janka-Schaub3, Alfred Reiter4, Georg Mann5, Kjeld Schmiegelow6, Richard Ratei7, Thomas Klingebiel8, Jörg Ritter9, Günter Henze1, for the ALL-REZ BFM Study Group 1 Department of Pediatric Oncology/Hematology, University of Berlin (Charité Universitätsmedizin Berlin), Berlin, Germany; 2 Basel University Children's Hospital, Basel, Switzerland; 3 Department of Pediatric Oncology/Hematology, University of Hamburg, Hamburg, Germany; 4 Department of Pediatric Oncology/Hematology, University of Giessen, Giessen, Germany; 5 St Anna Kinderspital, Department of Pediatric Hematology/Oncology, Vienna, Austria; 6 The Pediatric Clinic II, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark; 7 Department of Hematology, Oncology and Tumor Immunology, Robert-Roessle-Clinic at the HELIOS Klinikum Berlin, Germany; 8 Department of Pediatric Oncology/Hematology, University of Frankfurt, Frankfurt, Germany; and 9 Department of Pediatric Oncology/Hematology, University of Münster, Münster, Germany High-dose methotrexate (MTX) has been extensively used for treatment of acute lymphoblastic leukemia (ALL). To determine the optimal dose of MTX in childhood relapsed ALL, the ALL Relapse Berlin-Frankfurt-Münster (ALL-REZ BFM) Study Group performed this prospective randomized study. A total of 269 children with a first early/late isolated (n = 156) or combined (n = 68) bone marrow or any isolated extramedullary relapse (n = 45) of precursor B-cell (PBC) ALL (excluding very early marrow relapse within 18 months after initial diagnosis) were registered at the ALL-REZ BFM90 trial and randomized to receive methotrexate infusions at either 1 g/m2 over 36 hours (intermediate dose, ID) or 5 g/m2 over 24 hours (high dose, HD) during 6 (or 4) intensive polychemotherapy courses. Intensive induction/consolidation therapy was followed by cranial irradiation, and by conventional-dose maintenance therapy. Fifty-five children received stem-cell transplants. At a median follow-up of 14.1 years, the 10-year event-free survival probability was .36 (± .04) for the ID group (n = 141), and .38 (± .04) for the HD group (n = 128, P = .919). The 2 groups did not differ in terms of prognostic factors and other therapeutic parameters. In conclusion, methotrexate infusions at 5 g/m2 per 24 hours, compared with 1 g/m2 per 36 hours, are not associated with increased disease control in relapsed childhood PBC acute lymphoblastic leukemia. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: High-dose compared with intermediate-dose methotrexate in children with a first relapse of acute lymphatic leukemia Ian J. Cohen Blood 2008 112: 910. [Full Text] [PDF] This article has been cited by other articles: P. Bader, H. Kreyenberg, G. H.R. Henze, C. Eckert, M. Reising, A. Willasch, A. Barth, A. Borkhardt, C. Peters, R. Handgretinger, et al. Prognostic Value of Minimal Residual Disease Quantification Before Allogeneic Stem-Cell Transplantation in Relapsed Childhood Acute Lymphoblastic Leukemia: The ALL-REZ BFM Study Group J. Clin. Oncol., January 20, 2009; 27(3): 377 - 384. [Abstract] [Full Text] [PDF]

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