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Vincristine pharmacokinetics is related to clinical outcome in children with standard risk acute lymphoblastic leukemia
Lönnerholm, G., Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden, Department of Women's and Children's Health, University Children's Hospital, SE-751 85 Uppsala, Sweden.
Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
Queen Silvia Children's Hospital, Gothenburg, Sweden.
Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
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2008 (Engelska)Ingår i: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 142, nr 4, s. 616-621Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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 x 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. © 2008 The Authors.

Ort, förlag, år, upplaga, sidor
2008. Vol. 142, nr 4, s. 616-621
Nyckelord [en]
Acute lymphoblastic leukemia, Childhood, Drug effect, Pharmacokinetics, Vincristine
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-45589DOI: 10.1111/j.1365-2141.2008.07235.xOAI: oai:DiVA.org:liu-45589DiVA, id: diva2:266485
Tillgänglig från: 2009-10-11 Skapad: 2009-10-11 Senast uppdaterad: 2017-12-13

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