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Vincristine pharmacokinetics is related to clinical outcome in children with standard risk acute lymphoblastic leukemia

Vincristine pharmacokinetics is related to clinical outcome in children with standard risk acute... Vincristine is a key drug in the treatment of childhood and adult acute lymphoblastic leukemia (ALL), and many other childhood malignancies. Despite decades of wide clinical use, no data on the correlation between vincristine pharmacokinetics and long‐term clinical outcome have been published. We here report clinical data (median follow‐up time 10·5 years, range 7·3–12 years) for 86 children with B‐cell precursor ALL, in whom vincristine kinetics were studied on treatment day 1. The median total plasma clearance was 429 and 331 ml/min per m2 and the area under the plasma concentration‐time curve (AUC) was 4·49 and 5·40 mg/l × min in relapse and non‐relapse patients, respectively (not significant). In standard risk patients, where treatment depends more heavily on vincristine than in other subgroups, the relative risk (RR) of relapse was significantly increased for patients with clearance values above median (RR 5·2; P = 0·036), or AUC values below median (RR 5·8; P = 0·025). Our data suggest a relationship between the antileukemic effect and the systemic exposure of the drug, which warrants further studies. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png British Journal of Haematology Wiley

Vincristine pharmacokinetics is related to clinical outcome in children with standard risk acute lymphoblastic leukemia

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References (22)

Publisher
Wiley
Copyright
Copyright © 2008 Wiley Subscription Services
ISSN
0007-1048
eISSN
1365-2141
DOI
10.1111/j.1365-2141.2008.07235.x
pmid
18537965
Publisher site
See Article on Publisher Site

Abstract

Vincristine is a key drug in the treatment of childhood and adult acute lymphoblastic leukemia (ALL), and many other childhood malignancies. Despite decades of wide clinical use, no data on the correlation between vincristine pharmacokinetics and long‐term clinical outcome have been published. We here report clinical data (median follow‐up time 10·5 years, range 7·3–12 years) for 86 children with B‐cell precursor ALL, in whom vincristine kinetics were studied on treatment day 1. The median total plasma clearance was 429 and 331 ml/min per m2 and the area under the plasma concentration‐time curve (AUC) was 4·49 and 5·40 mg/l × min in relapse and non‐relapse patients, respectively (not significant). In standard risk patients, where treatment depends more heavily on vincristine than in other subgroups, the relative risk (RR) of relapse was significantly increased for patients with clearance values above median (RR 5·2; P = 0·036), or AUC values below median (RR 5·8; P = 0·025). Our data suggest a relationship between the antileukemic effect and the systemic exposure of the drug, which warrants further studies.

Journal

British Journal of HaematologyWiley

Published: Jan 1, 2008

Keywords: ; ; ; ;

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