High Dose Methotrexate in Treatment of Acute Lymphoblastic Leukemia: Toxicity Profile and Comparison of Tolerability Between Two Dosage Schedules.

Arun, Warrier (2009) High Dose Methotrexate in Treatment of Acute Lymphoblastic Leukemia: Toxicity Profile and Comparison of Tolerability Between Two Dosage Schedules. Masters thesis, Cancer Institute (WIA), Chennai.


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INTRODUCTION: The rate of success in the treatment of acute lymphoblastic leukemia (ALL) has increased steadily since the 1960s. The five-year event-free Survival rate is nearly 80 percent for children with ALL and Approximately 40 percent for adults.(1,2) Up to 80% of pediatric patients With acute lymphoblastic leukemia (ALL) can be cured if intensive Therapy is applied. Severe side effects may be encountered in all patients Of which, however, only the minority is life-threatening. The leading Cause of failure in childhood ALL is still recurrence of disease.Deciding About treatment protocol after risk stratification as followed by BFM Group is aimed at reducing relapses as well as treatment morbidity. One Of the important components is the introduction of High dose Methotrexate in the consolidation phase. This combined with cranial Radiotherapy in High risk group is postulated to prevent CNS relapses. (5,12). Methotrexate (MTX) is one of the most widely used anti-cancer agents, And administration of high-dose methotrexate (HDMTX) followed by Leucovorin (LV) rescue is an important component in the treatment of a Variety of childhood and adult cancers. HDMTX can be safely Administered to patients with normal renal function by the use of Alkalinization, hydration, and pharmacokinetically guided LV rescue. (15).Despite these measures, HDMTX-induced renal dysfunction Continues to occur in approximately 1.8% of patients with osteosarcoma Treated on clinical trials. Prompt recognition and treatment of mtxinduced Renal dysfunction are essential to prevent potentially lifethreatening MTX-associated toxicities, especially myelosuppression, Mucositis, and dermatitis.(26,27). Since the initiation of monitoring of MTX plasma concentrations and Appropriate alterations in leucovorin dosage and hydration, the frequency Of serious toxicity has been reduced and toxic deaths following HDMTX Have been virtually eliminated. This is an observational Nonrandomized study of clinical and biochemical variables to identify The risk factors associated with high-dose MTX therapy. There are limited data of complications resulting from treatment of ALL Incorporating high dose Methotrexate from developing countries like India, wherein besides the major risk factors, pharmacokinetic variables, Socioeconomic factors ,and other environmental factors also might play An important role. AIMS To study the toxicity profile of high dose methotrexate in Treatment of Acute Lymphoblastic Leukemia To compare between tolerability of 3gm/m2 and 5 gm/ m2 of high Dose methotrexate

Item Type: Thesis (Masters)
Uncontrolled Keywords: High Dose Methotrexate Treatment ; Acute Lymphoblastic ; Leukemia ; Toxicity Profile ; Comparison Tolerability ; Two Dosage Schedules.
Subjects: MEDICAL > Medical Oncology
Depositing User: Subramani R
Date Deposited: 19 Aug 2017 03:43
Last Modified: 19 Aug 2017 03:43
URI: http://repository-tnmgrmu.ac.in/id/eprint/2043

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