Comparison of methotrexate with 6‐mercaptopurine–prednisone in treatment of acute leukemia in adults

A randomized study of methotrexate vs. 6-mercaptopurine and prednisone was carried out in 45 previously untreated patients with acute leukemia. Methotrexate was given orally in divided daily doses for 5-day courses at intervals of ten to 14 days. Six-mercaptopurine and prednisone were given daily until toxicity or hematologic response occurred. Patients surviving 6 weeks and failing to respond to the first treatment regimen were switched to the second program. Five of 29 patients who received methotrexate either as first or second treatment responded—four with partial remissions and one with a complete remission. Eight of 34 patients who received 6-mercaptopurine and prednisone responded—two with complete remissions and six with partial remissions. The response rate in both groups of patients was low and there was no significant difference between the two groups. In a second unrandomized group of 20 patients treated with methotrexate there were two partial, responses.