High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia
Sixty-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) w...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-01-01
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| Series: | Leukemia Research Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213048918300463 |
| _version_ | 1811268934550159360 |
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| author | Wasil Jastaniah Naglla Elimam Khalid Abdalla Aeshah A. AlAzmi Mohammed Aseeri Sami Felimban |
| author_facet | Wasil Jastaniah Naglla Elimam Khalid Abdalla Aeshah A. AlAzmi Mohammed Aseeri Sami Felimban |
| author_sort | Wasil Jastaniah |
| collection | DOAJ |
| description | Sixty-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. Keywords: Acute lymphoblastic leukemia, High dose methotrexate, Central nervous system, T cell, Children |
| first_indexed | 2024-04-12T21:31:50Z |
| format | Article |
| id | doaj.art-f78858e7dea84b4fbd0d9d22bdf0c16d |
| institution | Directory Open Access Journal |
| issn | 2213-0489 |
| language | English |
| last_indexed | 2024-04-12T21:31:50Z |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Leukemia Research Reports |
| spelling | doaj.art-f78858e7dea84b4fbd0d9d22bdf0c16d2022-12-22T03:16:01ZengElsevierLeukemia Research Reports2213-04892018-01-01104451High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemiaWasil Jastaniah0Naglla Elimam1Khalid Abdalla2Aeshah A. AlAzmi3Mohammed Aseeri4Sami Felimban5Department of Pediatrics, Faculty of Medicine, Umm AlQura University, Makkah, Saudi Arabia; Princess Noorah Oncology Center, King Saud Bin Abdulaziz University for Health Sceinces, and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Corresponding author at: Department of Pediatrics, Faculty of Medicine, Umm AlQura University, Makkah, Saudi Arabia.Princess Noorah Oncology Center, King Saud Bin Abdulaziz University for Health Sceinces, and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaPrincess Noorah Oncology Center, King Saud Bin Abdulaziz University for Health Sceinces, and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaDepartment of Pharmaceutical Care, Clinical Pharmacy, Pediatric Hematology/Oncology, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaDepartment of Pharmaceutical Care, Clinical Pharmacy, Pediatric Hematology/Oncology, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaPrincess Noorah Oncology Center, King Saud Bin Abdulaziz University for Health Sceinces, and King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaSixty-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. Keywords: Acute lymphoblastic leukemia, High dose methotrexate, Central nervous system, T cell, Childrenhttp://www.sciencedirect.com/science/article/pii/S2213048918300463 |
| spellingShingle | Wasil Jastaniah Naglla Elimam Khalid Abdalla Aeshah A. AlAzmi Mohammed Aseeri Sami Felimban High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia Leukemia Research Reports |
| title | High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia |
| title_full | High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia |
| title_fullStr | High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia |
| title_full_unstemmed | High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia |
| title_short | High-dose methotrexate vs. Capizzi methotrexate for the treatment of childhood T-cell acute lymphoblastic leukemia |
| title_sort | high dose methotrexate vs capizzi methotrexate for the treatment of childhood t cell acute lymphoblastic leukemia |
| url | http://www.sciencedirect.com/science/article/pii/S2213048918300463 |
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