Acute Leukemia Treated With Divided Doses of Methotrexate

Abstract

THE REMISSION rates obtained with folic acid antagonists in acute leukemia in children have not been observed in adults. In a study by the Acute Leukemia B Group¹ methotrexate produced complete remissions in 22% of children with lymphoblastic leukemia. In adults given doses of 5 mg of methotrexate daily to the point of toxicity or remission a complete remission was obtained in only one of 34 patients with acute myelocytic leukemia. Others have reported remissions in less than 20% of adults using folic acid antagonists alone or in combination with mercaptopurine (6-mercaptopurine).^2-4 It has been stated that methotrexate is of no value in acute myelocytic leukemia in adults.⁵ Treatment with mercaptopurine has induced remissions in less than 20% of adult patients when strict criteria of response are imposed.^1,6 Combinations of prednisone and mercaptopurine reportedly induced remissions in one third of 36 patients reported by Bridges et