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document
Analysis of treatment in childhood leukaemia . I. Predisposition to methotrexate-induced neutropenia after craniospinal irradiation . Report to the Medical Research Council of the Working Party on Leukaemia in Childhood . The degree of drug-induced neutropenia resulting from a controlled trial ( UKALL I ) of treatment in acute lymphoblastic leukaemia was analysed . The main agent associated with severe neutropenia was methotrexate , and methotrexate-induced neutropenia was significantly greater in patients who had received craniospinal irradiation . The synergistic toxic effect of irradiation followed by methotrexate treatment seems to have contributed to three of the five deaths which occurred in complete remission in this trial ; all deaths in remission occurred in patients who had received central nervous system prophylaxis . Analysis of patients who subsequently relapsed compared with those still in remission after 18 months of treatment indicated that the former , on average , had slightly lower neutrophil counts . This suggests that the children who relapsed did not receive any less aggressive treatment than those who remained in remission .
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Intervention_Pharmacological
methotrexate
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Outcome_Other
Analysis of treatment
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Outcome_Adverse-effects
neutropenia
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Outcome_Adverse-effects
severe neutropenia
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Outcome_Adverse-effects
methotrexate-induced neutropenia
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Outcome_Adverse-effects
synergistic toxic effect of irradiation
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Outcome_Mortality
deaths
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Outcome_Physical
remission
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Outcome_Physical
neutrophil counts .