Flow cytometric analysis of marrow cell kinetics in children treated with high-dose MTX and CF rescue.

Normal marrow cell kinetics were studied by flow cytometry with computer analysis in 11 children with malignancies who received high-dose MTX followed by CF rescue. Nine children with hematological tumors in remission each received an infusion of MTX over 24 h, followed by delayed CF rescue. In 8 of the 9, an accumulation of cells in early to mid-S phase and a decrease of cells in G2/M phase were observed at 24-48 h after the beginning of the MTX infusion. At 144 h after MTX infusion this kinetic perturbation disappeared and the DNA histogram returned to the same state as before therapy. Two children who had malignant bone tumors without marrow infiltration each received an infusion of MTX over 6 h with early CF rescue following an initial IV injection of vincristine. They did not have any prominent perturbation of marrow cell kinetics after MTX exposure, except for a transient increase of cells in G2/M phase. These results confirm that with the high-dose MTX therapy described above for hematological malignancies the impairment of marrow cell kinetics was much more severe and was soon followed by complete recovery, whereas with the therapy for solid tumors the impairment was much slighter.