Methotrexate/L‐asparaginase combination chemotherapy for patients with acute leukemia in relapse: A study of 36 children

Abstract

Cyclic administration of methotrexate (MTX) and L‐Asparaginase (L‐Asp) was utilized either as induction and maintenance chemotherapy or as maintenance chemotherapy alone following induction with other medications in treating 36 children with multiple relapses of acute leukemia. A complete remission rate (CR) of 67% was obtained in children with null‐cell acute lymphocytic leukemia (ALL). The average length of remission was greater than four months. One of three patients with T‐cell ALL and one of two patients with B‐cell ALL achieved CR. In six cases of acute nonlymphocytic leukemia (ANLL), two patients achieved CR. One of two patients with terminal deoxynucleotidyl transferase (TdT) negative myeloblastic transformation of Ph'‐positive chronic myelogenous leukemia (CML) obtained a CR lasting 20 weeks. Toxicity secondary to the chemotherapy included bone marrow suppression, hepatic injury, nausea, diarrhea, stomatitis, and allergic reactions to L‐Asp. One case of subacute necrotizing leukoencephalopathy was seen. Copyright © 1980 American Cancer Society