scholarly journals Thiopurine dose intensity and treatment outcome in childhood lymphoblastic leukaemia: the influence of thiopurine methyltransferase pharmacogenetics

2014 ◽  
Vol 169 (2) ◽  
pp. 228-240 ◽  
Author(s):  
Lynne Lennard ◽  
Cher S. Cartwright ◽  
Rachel Wade ◽  
Ajay Vora
Keyword(s):  
Treatment Outcome ◽  
Lymphoblastic Leukaemia ◽  
Dose Intensity ◽  
Thiopurine Methyltransferase

The calculation of actual or received dose intensity: a comparison of published methods.

1991 ◽  
Vol 9 (11) ◽  
pp. 2042-2051 ◽  
Author(s):  
D L Longo ◽  
P L Duffey ◽  
V T DeVita ◽  
M N Wesley ◽  
S M Hubbard ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Prognostic Significance ◽  
Dose Intensity ◽  
The Other ◽  
Oncology Group ◽  
Southwest Oncology Group ◽  
Actual Treatment ◽  
Aggressive Histology ◽  
Impact On Treatment ◽  
Entire Treatment

Two recent reports of the same combination chemotherapy program, cyclophosphamide, doxorubicin, etoposide, methotrexate, cytarabine, vincristine, bleomycin, and prednisone (ProMACE-CytaBOM), in similar subsets of patients with advanced-stage aggressive-histology lymphoma used two different methods to report the actual dose-intensity (DI) data. One method treats DI as a property of a particular cycle of treatment within the entire population that received that cycle. The other treats DI as a characteristic of a particular patient's entire treatment course. We have applied both methods to the same set of data and provide evidence that the latter method is preferable for at least two reasons: (1) it more accurately reflects actual DI by clearly incorporating the duration of the actual treatment course and, thus, can be used to compare the administration of same or related regimens to distinct patient populations; and (2) it allows assignment of a numerical value to an individual patient's treatment course or a group of patients' treatment courses such that DI can be examined for its impact on treatment outcome just like any other prognostic factor. The observed differences in treatment outcome between the Southwest Oncology Group (SWOG) and National Cancer Institute (NCI) studies are not clearly related to differences in distribution of clinical prognostic factors in the two study populations. The differences in methods of reporting DI prohibit evaluation of the influence of dose-related variables on outcome in the two studies. Adoption of a standard method of calculating and reporting DI data would facilitate evaluation of the prognostic significance of DI.

Treatment Outcome of Aggressive Lymphoma with CyclOBEAP (CHOP-Like + Etoposide and Bleomycin): Results of Multicenter Trial.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3303-3303
Author(s):  
Masataka Okamoto ◽  
Nozomi Niitsu ◽  
Sadao Aoki ◽  
Yasunobu Kuraishi ◽  
Hirokazu Okumura ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Liver Damage ◽  
Performance Status ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Dose Intensity ◽  
Aggressive Lymphoma ◽  
Who Grade ◽  
Bulky Disease ◽  
Total Period

Abstract Introduction: To improve treatment outcome in aggressive lymphoma, a CHOP-like regimen with added etoposide and bleomycin was studied. Patients and Methods: Between April 1997 and March 2003, 126 consecutive patients (pts) with aggressive lymphoma of low-intermediate to high risk disease according to the age adjusted International Prognostic Index (IPI), age<61 years, and performance status(ECOG)<3 were treated with CyclOBEAP. MCL and ATL/L were excluded from this study. CyclOBEAP was a weekly protocol for a total period of 12 weeks. It consisted of doxorubicin 50mg/m2 given every 2 weeks in combination with either cyclophosphamide 1,000mg/m2 (weeks 1, 5, 9) or etoposide 70mg/m2 qd x4 (weeks 3, 7, 11). During the alternative weeks non-myelosuppressive vincristine 1.4mg/m2 (max. 2.0mg/body) was given either with bleomycin 10mg/m2 (weeks 2, 6, 10) or alone (weeks 4,8,12). Prednisolone 40mg/m2 was administered daily for 14 days during weeks 1–2, 5–6, and 9–10. Protocol dose intensity relative to that of CHOP was 1.5 for DXR, VCR and 1.0 for CPA. G-CSF was prophylactically used. Pts who had had a bulky disease at presentation received 40Gy of local irradiation after chemotherapy. Results: One hundred twenty-six pts were enrolled and 5 were excluded from analysis; 3 due to change of diagnosis ( ATL/L, Hodgkin lymphoma, germ cell tumor), 1 due to PS4 and the other due to drop out. In 121 eligible pts (DLBCL 94, PTCL 11, ALCL 7, nasal NK/T 4, others 5), 7 pts did not complete the full course of the treatment because of pneumonia (3), liver damage (1), intrathoracic hemorrhage (1), and PD response at 8th week (2). Relative given dose intensity was 0.94 for DXR, 0.95 for CPA, 0.86 for VCR, 0.94 for VP16, and 0.96 for BLM. All pts were evaluated. CR (including cCR) was obtained in 106 (88%), PR in 11 and NC/PD in 4. No treatment related death was observed. With a median follow-up of 56 months, 5yr overall survival (OS) rate is 72% and progression-free survival (PFS) rate is 62%. The 5yr OS and PFS within the subgroups defined by IPI and in pts with DLBCL and PTCL are not significantly different (data shown in the table). WHO grade 4 neutropenia was observed in 91 pts and thrombocytepenia in 13 pts. 66 pts required 2 or more units of red cell transfusions (2 – 66 units). Liver damage of grade 3 to 4 was seen in 3 pts. Conclusions: Addition of etoposide and bleomycin to CHOP drugs may enhance the effect of CHOP for aggressive lymphoma, encouraging comparative study between the two treatments. n CR (%) 5yr OS 5yr PFS *OS:Log-Rank 0.578; Wilcoxson 0.616 *PFS:Log-Rank 0.552; Wilcoxson 0.573 #OS:Log-Rank 0.049; Wilcoxson 0.059 #PFS:Log-Rank 0.122; Wilcoxson 0.146 All 121 106 ( 88) 72 % 62 % IPI: L-I* 41 37 ( 90) 69 65 IPI: H-I* 62 56 ( 90) 71 55 IPI: H* 18 13 ( 72) 82 43 DLBCL# 94 82 ( 87) 70 58 PTCL# 11 11 (100) 100 82

Thiopurine methyltransferase in acute lymphoblastic leukaemia: biochemical and molecular biological aspects

2005 ◽  
Vol 41 (4) ◽  
pp. 613-623 ◽  
Author(s):  
Connie Brouwer ◽  
Ronney A. De Abreu ◽  
Jenneke J. Keizer-Garritsen ◽  
Lambert H.J. Lambooy ◽  
Kai Ament ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Thiopurine Methyltransferase ◽  
Biological Aspects

Gender and treatment outcome in childhood lymphoblastic leukaemia: report from the MRC UKALL trials*

1995 ◽  
Vol 89 (2) ◽  
pp. 364-372 ◽  
Author(s):  
J. M. Chessells ◽  
S. M. Richards ◽  
C. C. Bailey ◽  
J. S. Lilleyman ◽  
O. B. Eden
Keyword(s):  
Treatment Outcome ◽  
Lymphoblastic Leukaemia

scholarly journals Impact of Nutrition on Treatment Outcome in Acute Lymphoblastic Leukaemia of Childhood in Developing Country

2012 ◽  
Vol 23 ◽  
pp. ix356
Author(s):  
S. Poddar ◽  
A. Mukhopadhyay ◽  
P. Hor ◽  
A. Nandi ◽  
P. Gupta ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Acute Lymphoblastic Leukaemia ◽  
Developing Country ◽  
Lymphoblastic Leukaemia
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