Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group
Identifieur interne : 000580 ( Canada/Analysis ); précédent : 000579; suivant : 000581Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group
Auteurs : Smita Bhatia [États-Unis] ; Wendy Landier [États-Unis] ; Muyun Shangguan [États-Unis] ; Lindsey Hageman [États-Unis] ; Alexandra N. Schaible [États-Unis] ; Andrea R. Carter [États-Unis] ; Cara L. Hanby [États-Unis] ; Wendy Leisenring [États-Unis] ; Yutaka Yasui [Canada] ; Nancy M. Kornegay [États-Unis] ; Leo Mascarenhas [États-Unis] ; A. Kim Ritchey [États-Unis] ; Jacqueline N. Casillas [États-Unis] ; David S. Dickens [États-Unis] ; Jane Meza [États-Unis] ; William L. Carroll [États-Unis] ; Mary V. Relling [États-Unis] ; F. Lennie Wong [États-Unis]Source :
- Journal of clinical oncology [ 0732-183X ] ; 2012.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Enfant.
English descriptors
- KwdEn :
Abstract
Purpose Systemic exposure to mercaptopurine (MP) is critical for durable remissions in children with acute lymphoblastic leukemia (ALL). Nonadherence to oral MP could increase relapse risk and also contribute to inferior outcome in Hispanics. This study identified determinants of adherence and described impact of adherence on relapse, both overall and by ethnicity. Patients and Methods A total of 327 children with ALL (169 Hispanic; 158 non-Hispanic white) participated. Medication event-monitoring system caps recorded date and time of MP bottle openings. Adherence rate, calculated monthly, was defined as ratio of days of MP bottle opening to days when MP was prescribed. Results After 53,394 person-days of monitoring, adherence declined from 94.7% (month 1) to 90.2% (month 6; P < .001). Mean adherence over 6 months was significantly lower among Hispanics (88.4% v 94.8%; P< .001), patients age ≥ 12 years (85.8% v 93.1%; P< .001), and patients from single-mother households (80.6% v 93.1%; P = .001). A progressive increase in relapse was observed with decreasing adherence (reference: adherence ≥ 95%; 94.9% to 90%: hazard ratio [HR], 4.1; 95% CI, 1.2 to 13.5; P = .02; 89.9% to 85%: HR, 4.0; 95% CI, 1.0 to 15.5; P = .04; < 85%: HR. 5.7; 95% CI, 1.9 to 16.8; P = .002). Cumulative incidence of relapse (± standard deviation) was higher among Hispanics (16.5% ± 4.0% v 6.3% ± 2.2%; P = .02). Association between Hispanic ethnicity and relapse (HR, 2.6; 95% CI, 1.1 to 6.1; P = .02) became nonsignificant (HR, 1.8; 95% CI, 0.6 to 5.2; P = .26) after adjusting for adherence and socioeconomic status. At adherence rates ≥ 90%, Hispanics continued to demonstrate higher relapse, whereas at rates < 90%, relapse risk was comparable to that of non-Hispanic whites. Conclusion Lower adherence to oral MP increases relapse risk. Ethnic difference in relapse risk differs by level of adherence-an observation currently under investigation.
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 003F62
- to stream PascalFrancis, to step Curation: 000F54
- to stream PascalFrancis, to step Checkpoint: 002E49
- to stream Main, to step Merge: 009135
- to stream Main, to step Curation: 008B40
- to stream Main, to step Exploration: 008B40
- to stream Canada, to step Extraction: 000580
Links to Exploration step
Pascal:12-0254227Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group</title><author><name sortKey="Bhatia, Smita" sort="Bhatia, Smita" uniqKey="Bhatia S" first="Smita" last="Bhatia">Smita Bhatia</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Landier, Wendy" sort="Landier, Wendy" uniqKey="Landier W" first="Wendy" last="Landier">Wendy Landier</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Shangguan, Muyun" sort="Shangguan, Muyun" uniqKey="Shangguan M" first="Muyun" last="Shangguan">Muyun Shangguan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Hageman, Lindsey" sort="Hageman, Lindsey" uniqKey="Hageman L" first="Lindsey" last="Hageman">Lindsey Hageman</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Schaible, Alexandra N" sort="Schaible, Alexandra N" uniqKey="Schaible A" first="Alexandra N." last="Schaible">Alexandra N. Schaible</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Carter, Andrea R" sort="Carter, Andrea R" uniqKey="Carter A" first="Andrea R." last="Carter">Andrea R. Carter</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>David Geffen School of Medicine, University of California</s1><s2>Los Angeles</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Los Angeles</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Hanby, Cara L" sort="Hanby, Cara L" uniqKey="Hanby C" first="Cara L." last="Hanby">Cara L. Hanby</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Leisenring, Wendy" sort="Leisenring, Wendy" uniqKey="Leisenring W" first="Wendy" last="Leisenring">Wendy Leisenring</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Fred Hutchinson Cancer Research Center</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Fred Hutchinson Cancer Research Center</wicri:noRegion></affiliation></author><author><name sortKey="Yasui, Yutaka" sort="Yasui, Yutaka" uniqKey="Yasui Y" first="Yutaka" last="Yasui">Yutaka Yasui</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Alberta</s1><s2>Edmonton, Alberta</s2><s3>CAN</s3><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Kornegay, Nancy M" sort="Kornegay, Nancy M" uniqKey="Kornegay N" first="Nancy M." last="Kornegay">Nancy M. Kornegay</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>10 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Mascarenhas, Leo" sort="Mascarenhas, Leo" uniqKey="Mascarenhas L" first="Leo" last="Mascarenhas">Leo Mascarenhas</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>University of Southern California Keck School of Medicine, Children's Hospital Los Angeles</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Kim Ritchey, A" sort="Kim Ritchey, A" uniqKey="Kim Ritchey A" first="A." last="Kim Ritchey">A. Kim Ritchey</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Casillas, Jacqueline N" sort="Casillas, Jacqueline N" uniqKey="Casillas J" first="Jacqueline N." last="Casillas">Jacqueline N. Casillas</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University of California</s1><s2>Los Angeles</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Los Angeles</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Dickens, David S" sort="Dickens, David S" uniqKey="Dickens D" first="David S." last="Dickens">David S. Dickens</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Spectrum Health at Butterworth Campus</s1><s2>Grand Rapids, MI</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Spectrum Health at Butterworth Campus</wicri:noRegion></affiliation></author><author><name sortKey="Meza, Jane" sort="Meza, Jane" uniqKey="Meza J" first="Jane" last="Meza">Jane Meza</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University of Nebraska Medical Center</s1><s2>Omaha, NE</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Nebraska Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Carroll, William L" sort="Carroll, William L" uniqKey="Carroll W" first="William L." last="Carroll">William L. Carroll</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>New York University Cancer Institute</s1><s2>New York, NY</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York University Cancer Institute</wicri:noRegion></affiliation></author><author><name sortKey="Relling, Mary V" sort="Relling, Mary V" uniqKey="Relling M" first="Mary V." last="Relling">Mary V. Relling</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>10 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lennie Wong, F" sort="Lennie Wong, F" uniqKey="Lennie Wong F" first="F." last="Lennie Wong">F. Lennie Wong</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0254227</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0254227 INIST</idno><idno type="RBID">Pascal:12-0254227</idno><idno type="wicri:Area/PascalFrancis/Corpus">003F62</idno><idno type="wicri:Area/PascalFrancis/Curation">000F54</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002E49</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">002E49</idno><idno type="wicri:doubleKey">0732-183X:2012:Bhatia S:nonadherence:to:oral</idno><idno type="wicri:Area/Main/Merge">009135</idno><idno type="wicri:Area/Main/Curation">008B40</idno><idno type="wicri:Area/Main/Exploration">008B40</idno><idno type="wicri:Area/Canada/Extraction">000580</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group</title><author><name sortKey="Bhatia, Smita" sort="Bhatia, Smita" uniqKey="Bhatia S" first="Smita" last="Bhatia">Smita Bhatia</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Landier, Wendy" sort="Landier, Wendy" uniqKey="Landier W" first="Wendy" last="Landier">Wendy Landier</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Shangguan, Muyun" sort="Shangguan, Muyun" uniqKey="Shangguan M" first="Muyun" last="Shangguan">Muyun Shangguan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Hageman, Lindsey" sort="Hageman, Lindsey" uniqKey="Hageman L" first="Lindsey" last="Hageman">Lindsey Hageman</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Schaible, Alexandra N" sort="Schaible, Alexandra N" uniqKey="Schaible A" first="Alexandra N." last="Schaible">Alexandra N. Schaible</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Carter, Andrea R" sort="Carter, Andrea R" uniqKey="Carter A" first="Andrea R." last="Carter">Andrea R. Carter</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>David Geffen School of Medicine, University of California</s1><s2>Los Angeles</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Los Angeles</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Hanby, Cara L" sort="Hanby, Cara L" uniqKey="Hanby C" first="Cara L." last="Hanby">Cara L. Hanby</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author><author><name sortKey="Leisenring, Wendy" sort="Leisenring, Wendy" uniqKey="Leisenring W" first="Wendy" last="Leisenring">Wendy Leisenring</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Fred Hutchinson Cancer Research Center</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Fred Hutchinson Cancer Research Center</wicri:noRegion></affiliation></author><author><name sortKey="Yasui, Yutaka" sort="Yasui, Yutaka" uniqKey="Yasui Y" first="Yutaka" last="Yasui">Yutaka Yasui</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Alberta</s1><s2>Edmonton, Alberta</s2><s3>CAN</s3><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Kornegay, Nancy M" sort="Kornegay, Nancy M" uniqKey="Kornegay N" first="Nancy M." last="Kornegay">Nancy M. Kornegay</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>10 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Mascarenhas, Leo" sort="Mascarenhas, Leo" uniqKey="Mascarenhas L" first="Leo" last="Mascarenhas">Leo Mascarenhas</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>University of Southern California Keck School of Medicine, Children's Hospital Los Angeles</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Kim Ritchey, A" sort="Kim Ritchey, A" uniqKey="Kim Ritchey A" first="A." last="Kim Ritchey">A. Kim Ritchey</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Casillas, Jacqueline N" sort="Casillas, Jacqueline N" uniqKey="Casillas J" first="Jacqueline N." last="Casillas">Jacqueline N. Casillas</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University of California</s1><s2>Los Angeles</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Los Angeles</settlement><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Dickens, David S" sort="Dickens, David S" uniqKey="Dickens D" first="David S." last="Dickens">David S. Dickens</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Spectrum Health at Butterworth Campus</s1><s2>Grand Rapids, MI</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Spectrum Health at Butterworth Campus</wicri:noRegion></affiliation></author><author><name sortKey="Meza, Jane" sort="Meza, Jane" uniqKey="Meza J" first="Jane" last="Meza">Jane Meza</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University of Nebraska Medical Center</s1><s2>Omaha, NE</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Nebraska Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Carroll, William L" sort="Carroll, William L" uniqKey="Carroll W" first="William L." last="Carroll">William L. Carroll</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>New York University Cancer Institute</s1><s2>New York, NY</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York University Cancer Institute</wicri:noRegion></affiliation></author><author><name sortKey="Relling, Mary V" sort="Relling, Mary V" uniqKey="Relling M" first="Mary V." last="Relling">Mary V. Relling</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>10 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lennie Wong, F" sort="Lennie Wong, F" uniqKey="Lennie Wong F" first="F." last="Lennie Wong">F. Lennie Wong</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>City of Hope</s1><s2>Duarte</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>City of Hope</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of clinical oncology</title><title level="j" type="abbreviated">J. clin. oncol.</title><idno type="ISSN">0732-183X</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of clinical oncology</title><title level="j" type="abbreviated">J. clin. oncol.</title><idno type="ISSN">0732-183X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute lymphocytic leukemia</term><term>Antineoplastic agent</term><term>Cancerology</term><term>Caucasoid</term><term>Child</term><term>Latinamerican</term><term>Malignant tumor</term><term>Mercaptopurine</term><term>Relapse</term><term>Risk factor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Mercaptopurine</term><term>Facteur risque</term><term>Récidive</term><term>Tumeur maligne</term><term>Latinoaméricain</term><term>Caucasoïde</term><term>Enfant</term><term>Leucémie aiguë lymphoblastique</term><term>Cancérologie</term><term>Anticancéreux</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Enfant</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose Systemic exposure to mercaptopurine (MP) is critical for durable remissions in children with acute lymphoblastic leukemia (ALL). Nonadherence to oral MP could increase relapse risk and also contribute to inferior outcome in Hispanics. This study identified determinants of adherence and described impact of adherence on relapse, both overall and by ethnicity. Patients and Methods A total of 327 children with ALL (169 Hispanic; 158 non-Hispanic white) participated. Medication event-monitoring system caps recorded date and time of MP bottle openings. Adherence rate, calculated monthly, was defined as ratio of days of MP bottle opening to days when MP was prescribed. Results After 53,394 person-days of monitoring, adherence declined from 94.7% (month 1) to 90.2% (month 6; P < .001). Mean adherence over 6 months was significantly lower among Hispanics (88.4% v 94.8%; P< .001), patients age ≥ 12 years (85.8% v 93.1%; P< .001), and patients from single-mother households (80.6% v 93.1%; P = .001). A progressive increase in relapse was observed with decreasing adherence (reference: adherence ≥ 95%; 94.9% to 90%: hazard ratio [HR], 4.1; 95% CI, 1.2 to 13.5; P = .02; 89.9% to 85%: HR, 4.0; 95% CI, 1.0 to 15.5; P = .04; < 85%: HR. 5.7; 95% CI, 1.9 to 16.8; P = .002). Cumulative incidence of relapse (± standard deviation) was higher among Hispanics (16.5% ± 4.0% v 6.3% ± 2.2%; P = .02). Association between Hispanic ethnicity and relapse (HR, 2.6; 95% CI, 1.1 to 6.1; P = .02) became nonsignificant (HR, 1.8; 95% CI, 0.6 to 5.2; P = .26) after adjusting for adherence and socioeconomic status. At adherence rates ≥ 90%, Hispanics continued to demonstrate higher relapse, whereas at rates < 90%, relapse risk was comparable to that of non-Hispanic whites. Conclusion Lower adherence to oral MP increases relapse risk. Ethnic difference in relapse risk differs by level of adherence-an observation currently under investigation.</div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Californie</li></region><settlement><li>Los Angeles</li></settlement></list><tree><country name="États-Unis"><noRegion><name sortKey="Bhatia, Smita" sort="Bhatia, Smita" uniqKey="Bhatia S" first="Smita" last="Bhatia">Smita Bhatia</name></noRegion><name sortKey="Carroll, William L" sort="Carroll, William L" uniqKey="Carroll W" first="William L." last="Carroll">William L. Carroll</name><name sortKey="Carter, Andrea R" sort="Carter, Andrea R" uniqKey="Carter A" first="Andrea R." last="Carter">Andrea R. Carter</name><name sortKey="Casillas, Jacqueline N" sort="Casillas, Jacqueline N" uniqKey="Casillas J" first="Jacqueline N." last="Casillas">Jacqueline N. Casillas</name><name sortKey="Dickens, David S" sort="Dickens, David S" uniqKey="Dickens D" first="David S." last="Dickens">David S. Dickens</name><name sortKey="Hageman, Lindsey" sort="Hageman, Lindsey" uniqKey="Hageman L" first="Lindsey" last="Hageman">Lindsey Hageman</name><name sortKey="Hanby, Cara L" sort="Hanby, Cara L" uniqKey="Hanby C" first="Cara L." last="Hanby">Cara L. Hanby</name><name sortKey="Kim Ritchey, A" sort="Kim Ritchey, A" uniqKey="Kim Ritchey A" first="A." last="Kim Ritchey">A. Kim Ritchey</name><name sortKey="Kornegay, Nancy M" sort="Kornegay, Nancy M" uniqKey="Kornegay N" first="Nancy M." last="Kornegay">Nancy M. Kornegay</name><name sortKey="Landier, Wendy" sort="Landier, Wendy" uniqKey="Landier W" first="Wendy" last="Landier">Wendy Landier</name><name sortKey="Leisenring, Wendy" sort="Leisenring, Wendy" uniqKey="Leisenring W" first="Wendy" last="Leisenring">Wendy Leisenring</name><name sortKey="Lennie Wong, F" sort="Lennie Wong, F" uniqKey="Lennie Wong F" first="F." last="Lennie Wong">F. Lennie Wong</name><name sortKey="Mascarenhas, Leo" sort="Mascarenhas, Leo" uniqKey="Mascarenhas L" first="Leo" last="Mascarenhas">Leo Mascarenhas</name><name sortKey="Meza, Jane" sort="Meza, Jane" uniqKey="Meza J" first="Jane" last="Meza">Jane Meza</name><name sortKey="Relling, Mary V" sort="Relling, Mary V" uniqKey="Relling M" first="Mary V." last="Relling">Mary V. Relling</name><name sortKey="Schaible, Alexandra N" sort="Schaible, Alexandra N" uniqKey="Schaible A" first="Alexandra N." last="Schaible">Alexandra N. Schaible</name><name sortKey="Shangguan, Muyun" sort="Shangguan, Muyun" uniqKey="Shangguan M" first="Muyun" last="Shangguan">Muyun Shangguan</name></country><country name="Canada"><noRegion><name sortKey="Yasui, Yutaka" sort="Yasui, Yutaka" uniqKey="Yasui Y" first="Yutaka" last="Yasui">Yutaka Yasui</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Canada/Analysis
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000580 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Canada/Analysis/biblio.hfd -nk 000580 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Amérique
|area= PittsburghV1
|flux= Canada
|étape= Analysis
|type= RBID
|clé= Pascal:12-0254227
|texte= Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group
}}
| This area was generated with Dilib version V0.6.38. |  |