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Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation

Journal Article:

Abstract

This study was designed to evaluate the efficacy of CNS-prophylaxis with high-dose methotrexate (MTX). Seventy children with previously untreated acute lymphoblastic leukemia (ALL) entered to this study between July 1978 and December 1980. According to initial white blood count (WBC), they were stratified to induce remission with; vincristine and prednine in low initial WBC ( lt 25,000/mm/sup 3/) group and these two agents plus adriamycin in high initial WBC ( gt 25,000/mm/sup 3/) group. After inducing remission, 62 children who achieved CR, received different CNS-prophlaxis; using a regimen of three doses of weekly high-dose MTX (1,000 mg/m/sup 2/) 6-hour infusion, which was repeated every 12 weeks-Group A (n = 14); high-dose MTX followed by 2400 rad cranial irradiation plus three doses of i.t. MT X-Group B (n = 15), 2400 rad cranial irradiation plus three doses of i.t. MTX-Group C (n = 16), and in 17 patients with high initial WBC, same as in Group A-Group D (n = 17). During an intravenous 6-h infusion of MTX at a dose of 1,000 mg/m/sup 2/, the CSF concentration of MTX rose to 2.3 +- 2.4 x 10/sup -6/M after initiation of infusion and remained in 10/sup -7/ M level for 48  More>>
Authors:
Yokoyama, Takashi; Hiyoshi, Yasuhiko; [1]  Fujimoto, Takeo
  1. Kurume Univ., Fukuoka (Japan). School of Medicine
Publication Date:
Dec 01, 1982
Product Type:
Journal Article
Reference Number:
AIX-15-025083; EDB-84-086361
Resource Relation:
Journal Name: Rinsho Ketsueki; (Japan); Journal Volume: 23:12
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHILDREN; LEUKEMIA; RADIOTHERAPY; CHEMOTHERAPY; INTRAVENOUS INJECTION; IRRADIATION; LEUKOCYTES; METHOTREXATE; NERVOUS SYSTEM DISEASES; PATIENTS; SKULL; TIME DEPENDENCE; AGE GROUPS; ANTIMETABOLITES; BIOLOGICAL MATERIALS; BLOOD; BLOOD CELLS; BODY; BODY FLUIDS; DISEASES; DRUGS; HEMIC DISEASES; INJECTION; INTAKE; MATERIALS; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; SKELETON; THERAPY; 550601* - Medicine- Unsealed Radionuclides in Diagnostics
OSTI ID:
6965119
Country of Origin:
Japan
Language:
Japanese
Other Identifying Numbers:
Journal ID: CODEN: RIKEB
Submitting Site:
HEDB
Size:
Pages: 1863-1870
Announcement Date:
Mar 01, 1984

Journal Article:

Citation Formats

Yokoyama, Takashi, Hiyoshi, Yasuhiko, and Fujimoto, Takeo. Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation. Japan: N. p., 1982. Web.
Yokoyama, Takashi, Hiyoshi, Yasuhiko, & Fujimoto, Takeo. Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation. Japan.
Yokoyama, Takashi, Hiyoshi, Yasuhiko, and Fujimoto, Takeo. 1982. "Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation." Japan.
@misc{etde_6965119,
title = {Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation}
author = {Yokoyama, Takashi, Hiyoshi, Yasuhiko, and Fujimoto, Takeo}
abstractNote = {This study was designed to evaluate the efficacy of CNS-prophylaxis with high-dose methotrexate (MTX). Seventy children with previously untreated acute lymphoblastic leukemia (ALL) entered to this study between July 1978 and December 1980. According to initial white blood count (WBC), they were stratified to induce remission with; vincristine and prednine in low initial WBC ( lt 25,000/mm/sup 3/) group and these two agents plus adriamycin in high initial WBC ( gt 25,000/mm/sup 3/) group. After inducing remission, 62 children who achieved CR, received different CNS-prophlaxis; using a regimen of three doses of weekly high-dose MTX (1,000 mg/m/sup 2/) 6-hour infusion, which was repeated every 12 weeks-Group A (n = 14); high-dose MTX followed by 2400 rad cranial irradiation plus three doses of i.t. MT X-Group B (n = 15), 2400 rad cranial irradiation plus three doses of i.t. MTX-Group C (n = 16), and in 17 patients with high initial WBC, same as in Group A-Group D (n = 17). During an intravenous 6-h infusion of MTX at a dose of 1,000 mg/m/sup 2/, the CSF concentration of MTX rose to 2.3 +- 2.4 x 10/sup -6/M after initiation of infusion and remained in 10/sup -7/ M level for 48 hours. CNS-leukemia terminated complete remission in one of 14 children in Group A, two of 15 in Group B, two of 16 in Group C and two of 17 in Group D. The cumulative incidence of CNS-leukemia at 20 months calculated by the technique of Kaplan and Meier was 0% in Group A, 18.1% in Group B, 7.1% in Group C and 50.8% in Group D. There was no statistical difference among Groups A, B and C. These data suggested that CNS-prophylaxis with high-dose intravenous MTX was effective as well as 2400 rad cranial irradiation plus three doses of i.t. MTX in childhood ALL with low initial WBC.}
journal = {Rinsho Ketsueki; (Japan)}
volume = {23:12}
journal type = {AC}
place = {Japan}
year = {1982}
month = {Dec}
}