METHOTREXATE SYSTEMIC CLEARANCE INFLUENCES PROBABILITY OF RELAPSE IN CHILDREN WITH STANDARD-RISK ACUTE LYMPHOCYTIC LEUKAEMIA
Identifieur interne : 003639 ( Main/Merge ); précédent : 003638; suivant : 003640METHOTREXATE SYSTEMIC CLEARANCE INFLUENCES PROBABILITY OF RELAPSE IN CHILDREN WITH STANDARD-RISK ACUTE LYMPHOCYTIC LEUKAEMIA
Auteurs : Williame. Evans [Royaume-Uni] ; Clintonf. Stewart [Royaume-Uni] ; Chen-Hsin Chen [Royaume-Uni] ; Williamr. Crom [Royaume-Uni] ; W. Paul Bowman [Royaume-Uni] ; Minnie Abromowitch [Royaume-Uni] ; Josephv. Simone [Royaume-Uni]Source :
- The Lancet [ 0140-6736 ] ; 1984.
English descriptors
- Teeft :
- Amodiaquine, Cerebrospinal fluid, Chloroquine, Chloroquine resistance, Clearance, Clearance groups, Clin pharmacol, Complete remission, Daily mercaptopurine, Dos, Drug clearance, Enzyme immunoassay, Falciparum, Falciparum malaria, Greater risk, Haematological, Haematological relapse, Haematological relapses, Haemoglobin, Haemoglobin level, Human lymphoblastoid cells, Infusion, Jude research hospital, Kenya, Leucovorin rescue, Linear regression analysis, Median, Median methotrexate, Medium clearance groups, Melatonin, Methotrexate, Methotrexate clearance, Methotrexate doses, Methotrexate infusion, Methotrexate infusions, Methotrexate therapy, Multivariate analysis, Pharmaceutical division, Plasmodium, Plasmodium falciparum, Plasmodium falciparum malaria, Prepubertal children, Previous studies, Prognostic variables, Relapse, Remission, Remission duration, Sample collection, Serum concentrations, Serum methotrexate concentrations, Sexual maturation, Sodium chloride, Systemic clearance, Testicular relapse, Weekly methotrexate, Young adults.
Abstract
Abstract: 108 children with standard-risk acute lymphocytic leukaemia (ALL) were randomised to a post-induction treatment protocol including 15 doses of intermediate-dose methotrexate (1000 mg/m2) in addition to conventional oral therapy of mercaptopurine and low-dose methotrexate. After median follow-up of 26 months, 22 patients have had relapses. Among the 108 patients, rates of methotrexate systemic clearance ranged from 44·7 to 132 ml/min/m2. When the group was divided into three subgroups according to the patients' rates of methotrexate clearance, statistical analysis of the Kaplan-Meier curves estimating the probability of complete remission showed significant differences (p=0·016) among the subgroups, patients with faster clearance having higher probability of relapse. Multivariate Cox's regression analysis incorporating other potential prognostic variables identified three significant variables influencing the risk of relapse—methotrexate clearance and white-blood-cell count and haemoglobin level at diagnosis (p=0·0015). This study has demonstrated the potential clinical importance of the rate of drug clearance in children with ALL.
Url:
DOI: 10.1016/S0140-6736(84)90411-2
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Simone</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Pharmacokinetics and Pharmacodynamics Section, Pharmaceutical Division, Division of Hematology and Oncology, and Biostatistics Section, St Jude Children's Research Hospital, Memphis, Tennessee, USA</wicri:regionArea><wicri:noRegion>USA</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">The Lancet</title><title level="j" type="abbrev">LANCET</title><idno type="ISSN">0140-6736</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1984">1984</date><biblScope unit="volume">323</biblScope><biblScope unit="issue">8373</biblScope><biblScope unit="page" from="359">359</biblScope><biblScope unit="page" to="362">362</biblScope></imprint><idno type="ISSN">0140-6736</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0140-6736</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Amodiaquine</term><term>Cerebrospinal fluid</term><term>Chloroquine</term><term>Chloroquine resistance</term><term>Clearance</term><term>Clearance groups</term><term>Clin pharmacol</term><term>Complete remission</term><term>Daily mercaptopurine</term><term>Dos</term><term>Drug clearance</term><term>Enzyme immunoassay</term><term>Falciparum</term><term>Falciparum malaria</term><term>Greater risk</term><term>Haematological</term><term>Haematological relapse</term><term>Haematological relapses</term><term>Haemoglobin</term><term>Haemoglobin level</term><term>Human lymphoblastoid cells</term><term>Infusion</term><term>Jude research hospital</term><term>Kenya</term><term>Leucovorin rescue</term><term>Linear regression analysis</term><term>Median</term><term>Median methotrexate</term><term>Medium clearance groups</term><term>Melatonin</term><term>Methotrexate</term><term>Methotrexate clearance</term><term>Methotrexate doses</term><term>Methotrexate infusion</term><term>Methotrexate infusions</term><term>Methotrexate therapy</term><term>Multivariate analysis</term><term>Pharmaceutical division</term><term>Plasmodium</term><term>Plasmodium falciparum</term><term>Plasmodium falciparum malaria</term><term>Prepubertal children</term><term>Previous studies</term><term>Prognostic variables</term><term>Relapse</term><term>Remission</term><term>Remission duration</term><term>Sample collection</term><term>Serum concentrations</term><term>Serum methotrexate concentrations</term><term>Sexual maturation</term><term>Sodium chloride</term><term>Systemic clearance</term><term>Testicular relapse</term><term>Weekly methotrexate</term><term>Young adults</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: 108 children with standard-risk acute lymphocytic leukaemia (ALL) were randomised to a post-induction treatment protocol including 15 doses of intermediate-dose methotrexate (1000 mg/m2) in addition to conventional oral therapy of mercaptopurine and low-dose methotrexate. After median follow-up of 26 months, 22 patients have had relapses. Among the 108 patients, rates of methotrexate systemic clearance ranged from 44·7 to 132 ml/min/m2. When the group was divided into three subgroups according to the patients' rates of methotrexate clearance, statistical analysis of the Kaplan-Meier curves estimating the probability of complete remission showed significant differences (p=0·016) among the subgroups, patients with faster clearance having higher probability of relapse. Multivariate Cox's regression analysis incorporating other potential prognostic variables identified three significant variables influencing the risk of relapse—methotrexate clearance and white-blood-cell count and haemoglobin level at diagnosis (p=0·0015). This study has demonstrated the potential clinical importance of the rate of drug clearance in children with ALL.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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