Key clinical point: An escalating methotrexate strategy improved survival, compared with high-dose methotrexate, in T-cell acute lymphoblastic leukemia (T-ALL).
Major finding: The 5-year disease-free survival rate was 91.5% versus 85.3% (P = .005) and overall survival was 93.7% versus 89.4% (P = .036), respectively, for the escalating and high-dose approaches.
Study details: Results after methotrexate randomization in 1,031 T-ALL patients without CNS3 disease or testicular leukemia in the Children’s Oncology Group (COG) AALL0434 trial.
Disclosures: The study was supported by grants from the National Institutes of Health and by St. Baldrick’s Foundation. The authors reported disclosures related to Amgen, Jazz Pharmaceuticals, Novo Nordisk, Tandem, Pfizer, Novartis, and TypeZero Technologies, among others.
Winter SS et al. J Clin Oncol. 2018 Aug 23. doi : 10.1200/JCO.2018.77.7250.
This Week's Must Reads
Study examines rehabilitative palliative care in cancer, Nottelmann L et al. 2018 Palliative and Supportive Care in Oncology Symposium Abstract 75
HSCT performs well in scleroderma-related lung disease, Goldin J et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 901
Phase 2 results for combo therapy in relapsed AML, Daver N et al. Cancer Discov. 2018 Nov 8. doi: 10.1158/2159-8290.CD-18-0774
RNA editing contributes to myeloma pathogenesis, Teoh PJ et al. Blood. 2018;132(12):1304-17
Transcription factor networks in AML, Assi SA et al. Nat Genet. 2018 Nov 12. doi: 10.1038/s41588-018-0270-1
Must Reads in ALL (Acute Lymphoblastic Leukemia)
Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.
CAR T-cell cost effectiveness in ALL, Whittington MD et al. JAMA Pediatr. 2018 Oct 8. doi: 10.1001/jamapediatrics.2018.2530
CAR T induced resistance in ALL, Ruella M et al. Nat Med. 2018 Oct 1. doi: 10.1038/s41591-018-0201-9
ALL complications carry cognitive risks, Cheung YT et al. JAMA Pediatr. 2018 Sep 24. doi:10.1001/jamapediatrics.2018.2500.
Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004