ArticleLeukemia2010
The degree of myelosuppression during maintenance therapy of adolescents with B-lineage intermediate risk acute lymphoblastic leukemia predicts risk of relapse.
Article in Leukemia, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 43 citations in OpenAlex.
- Excellent Outcomes With Reduced Frequency of Vincristine and Dexamethasone Pulses in Standard-Risk B-Lymphoblastic Leukemia: Results From Children's Oncology Group AALL0932.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Trial
- Improved prognosis for older adolescents with acute lymphoblastic leukemia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2011Trial
- Article
- Challenges to successful outcomes in AYAs with ALL and potential solutions.Hematology. American Society of Hematology. Education Program · 2023Article
- An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL.Blood advances · 2021Article
- Pediatric-inspired protocols in adult acute lymphoblastic leukemia: are the results bearing fruit?Hematology. American Society of Hematology. Education Program · 2019Article
- Results of NOPHO ALL2008 treatment for patients aged 1-45 years with acute lymphoblastic leukemia.Leukemia · 2018Article
- Prognostic significance of leukopenia during the induction phase in adult B cell acute lymphoblastic leukemia.Cancer management and research · 2018Article
- Influence of dihydrofolate reductase gene polymorphisms rs408626 (-317A>G) and rs442767 (-680C>A) on the outcome of methotrexate-based maintenance therapy in South Indian patients with acute lymphoblastic leukemia.European journal of clinical pharmacology · 2015Article
- Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2015Article
- Review
- Treatment of pediatric acute lymphoblastic leukemia.Pediatric clinics of North America · 2015Review
- Mercaptopurine/Methotrexate maintenance therapy of childhood acute lymphoblastic leukemia: clinical facts and fiction.Journal of pediatric hematology/oncology · 2014Review
- Treatment of adolescent and young adults with acute lymphoblastic leukemia.Mediterranean journal of hematology and infectious diseases · 2014Review
- Challenges in implementing individualized medicine illustrated by antimetabolite therapy of childhood acute lymphoblastic leukemia.Clinical proteomics · 2011Article
- Optimal therapy for acute lymphoblastic leukemia in adolescents and young adults.Nature reviews. Clinical oncology · 2011Review
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Authors and funding
11 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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