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January 1965

Acute Leukemia Treated With Divided Doses of Methotrexate

Author Affiliations


Associate Professor of Medicine (Dr. Huguley), Associate in Medicine (Dr. Vogler), Associate in Medicine (Dr. Lea), Assistant Professor of Medicine (Dr. Corley), and Fellow in Medicine (Dr. Lowrey), Emory University.

Arch Intern Med. 1965;115(1):23-28. doi:10.1001/archinte.1965.03860130025004

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