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Acute Leukemia Treated With Divided Doses of Methotrexate

CHARLES M. HUGULEY JR., MD; WILLIAM R. VOGLER, MD; JAMES W. LEA, MD; CHARLES C. CORLEY JR., MD; MICHAEL E. LOWREY, MD
Arch Intern Med. 1965;115(1):23-28. doi:10.1001/archinte.1965.03860130025004.
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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

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