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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2010-4-14
pubmed:abstractText
Drug doses, blood levels of drug metabolites and myelotoxicity during 6-mercaptopurine/methotrexate (MTX) maintenance therapy were registered for 59 adolescents (>or=10 years) and 176 non-adolescents (<10 years) with B-cell precursor acute lymphoblastic leukemia (ALL) and a white blood cell count (WBC) <50 x 10(9)/l at diagnosis. Event-free survival was lower for adolescents than non-adolescents (pEFS(12y):0.71 vs 0.83, P=0.04). For adolescents staying in remission, the mean WBC during maintenance therapy (mWBC) was related to age (r(S)=0.36, P=0.02), which became nonsignificant for those who relapsed (r(S)=0.05, P=0.9). The best-fit multivariate Cox regression model to predict risk of relapse included mWBC and thiopurine methyltransferase activity, which methylates mercaptopurine and reduces the intracellular availability of cytotoxic 6-thioguanine nucleotides (coefficient: 0.11, P=0.02). The correlation of mWBC to the risk of relapse was more pronounced for adolescents (coefficient=0.65, P=0.003) than for non-adolescents (coefficient=0.42, P=0.04). Adolescents had higher mean neutrophil counts (P=0.002) than non-adolescents, but received nonsignificantly lower mercaptopurine and MTX doses during maintenance therapy. Red blood cell MTX levels were significantly related to the dose of MTX among adolescents who stayed in remission (r(S)=0.38, P=0.02), which was not the case for those who developed a relapse (r(S)=0.15, P=0.60). Thus, compliance to maintenance therapy may influence the risk of relapse for adolescents with ALL.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1476-5551
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
24
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
715-20
pubmed:meshHeading
pubmed-meshheading:20130603-6-Mercaptopurine, pubmed-meshheading:20130603-Adolescent, pubmed-meshheading:20130603-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:20130603-Bone Marrow, pubmed-meshheading:20130603-Child, pubmed-meshheading:20130603-Child, Preschool, pubmed-meshheading:20130603-Female, pubmed-meshheading:20130603-Humans, pubmed-meshheading:20130603-Infant, pubmed-meshheading:20130603-Leukocyte Count, pubmed-meshheading:20130603-Male, pubmed-meshheading:20130603-Methotrexate, pubmed-meshheading:20130603-Methyltransferases, pubmed-meshheading:20130603-Neoplasm Recurrence, Local, pubmed-meshheading:20130603-Neutrophils, pubmed-meshheading:20130603-Precursor B-Cell Lymphoblastic Leukemia-Lymphoma, pubmed-meshheading:20130603-Risk Factors, pubmed-meshheading:20130603-Survival Rate, pubmed-meshheading:20130603-Treatment Outcome
pubmed:year
2010
pubmed:articleTitle
The degree of myelosuppression during maintenance therapy of adolescents with B-lineage intermediate risk acute lymphoblastic leukemia predicts risk of relapse.
pubmed:affiliation
Department of Pediatric Oncology, The University Hospital Rigshospitalet, Copenhagen, Denmark. kschmiegelow@rh.dk
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't