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Blood, 15 December 2006, Vol. 108, No. 13, pp. 3997-4002.
Prepublished online as a Blood First Edition Paper on August 17, 2006; DOI 10.1182/blood-2006-05-024414.
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CLINICAL TRIALS AND OBSERVATIONS
Body mass index does not influence pharmacokinetics or outcome of treatment in children with acute lymphoblastic leukemia
Nobuko Hijiya,
John C. Panetta,
Yinmei Zhou,
Emily P. Kyzer,
Scott C. Howard,
Sima Jeha,
Bassem I. Razzouk,
Raul C. Ribeiro,
Jeffrey E. Rubnitz,
Melissa M. Hudson,
John T. Sandlund,
Ching-Hon Pui, and
Mary V. Relling
From the Departments of Oncology, Pharmaceutical Sciences, and Biostatistics, St Jude Children's Research Hospital, Memphis, TN; and the Departments of Pediatrics, Pharmaceutical Sciences, and Pharmacy and the Center for Pediatric Pharmacokinetics and Therapeutics, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN.
There is conflicting information about the influence of body mass index (BMI) on the pharmacokinetics, toxicity, and outcome of chemotherapy. We compared pharmacokinetics, outcome, and toxicity data across 4 BMI groups (underweight, BMI  10th percentile; normal; at risk of overweight, BMI  85th and < 95th percentile; overweight, BMI 95th percentile) in 621 children with acute lymphoblastic leukemia (ALL) treated on 4 consecutive St Jude Total Therapy studies. Chemotherapy doses were not adjusted to ideal BMI. Estimates of overall survival (86.1% ± 3.4%, 86.0% ± 1.7%, 85.9% ± 4.3%, and 78.2% ± 5.5%, respectively; P = .533), event-free survival (76.2% ± 4.2%, 78.7% ± 2.1%, 73.4% ± 5.5%, and 72.7% ± 5.9%, respectively; P = .722), and cumulative incidence of relapse (16.0% ± 3.7%, 14.4% ± 1.8%, 20.6% ± 5.1%, and 16.7% ± 5.1%, respectively; P = .862) did not differ across the 4 groups. In addition, the intracellular levels of thioguanine nucleotides and methotrexate polyglutamates did not differ between the 4 BMI groups (P = .73 and P = .74, respectively). The 4 groups also did not differ in the overall incidence of grade 3 or 4 toxicity during the induction or postinduction periods. Further, the systemic clearance of methotrexate, teniposide, etoposide, and cytarabine did not differ with BMI (P > .3). We conclude that BMI does not affect the outcome or toxicity of chemotherapy in this patient population with ALL.
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T. S. Jones, S. C. Kaste, W. Liu, C. Cheng, W. Yang, K. G. Tantisira, C.-H. Pui, and M. V. Relling
CRHR1 Polymorphisms Predict Bone Density in Survivors of Acute Lymphoblastic Leukemia
J. Clin. Oncol.,
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26(18):
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[Abstract]
[Full Text]
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