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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 (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 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 Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 24, 2007 Accepted November 1, 2007 High-dose as compared with intermediate-dose methotrexate in children with a first relapse of acute lymphoblastic leukemia Arend von Stackelberg*, Reinhard Hartmann, Christoph Buhrer, Rudiger Fengler, Gritta Janka-Schaub, Alfred Reiter, Georg Mann, Kjeld Schmiegelow, Richard Ratei, Thomas Klingebiel, Jorg Ritter, and Gunter Henze Departments of Pediatric Oncology/Hematology, University of Berlin, Charite Medical Center Berlin, Berlin, Germany Department of Neonatology, Basel University Children's Hospital, Basel, Switzerland Departments of Pediatric Oncology/Hematology, Hamburg University Hospital, Hamburg, Germany Departments of Pediatric Oncology/Hematology, Giessen University Hospital, Giessen, Germany Departments of Pediatric Oncology/Hematology, St. Anna Kinderspital, Vienna, Austria The Pediatric Clinic II, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark Department of Hematology, Oncology and Tumor Immunology, Robert-Roessle-Clinic at the HELIOS Klinik, Berlin, Germany Departments of Pediatric Oncology/Hematology, Frankfurt University Hospital, Frankfurt, Germany Departments of Pediatric Oncology/Hematology, Munster University Hospital, Munster, Germany * Corresponding author; email: arend.stackelberg{at}charite.de. 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-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 1g/m2 over 36h (intermediate dose, ID) or 5g/m2 over 24h (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 two groups did not differ in terms of prognostic factors and other therapeutic parameters. Conclusion. Methotrexate infusions at 5 g/m2/24h, as compared with 1 g/m2/36h, 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: B. Burkhardt, A. Reiter, E. Landmann, P. Lang, L. Lassay, R. Dickerhoff, M. Lakomek, G. Henze, and A. von Stackelberg Poor Outcome for Children and Adolescents With Progressive Disease or Relapse of Lymphoblastic Lymphoma: A Report From the Berlin-Frankfurt-Muenster Group J. Clin. Oncol., July 10, 2009; 27(20): 3363 - 3369. [Abstract] [Full Text] [PDF] 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] I. J. Cohen High-dose compared with intermediate-dose methotrexate in children with a first relapse of acute lymphatic leukemia Blood, August 1, 2008; 112(3): 910 - 910. [Full Text] [PDF]

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