| Malnourished Malawian patients presenting with large Wilms tumours have a decreased vincristine clearance rate. | |
| | |
MedLine Citation:
|
PMID: 20382523 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: In developing countries, patients with a Wilms' tumour often present late with a high degree of malnutrition and large tumours. We investigated whether this affects vincristine pharmacokinetics. METHODS: Patients newly diagnosed with Wilms' tumour in Malawi and the UK were included. We documented anthropometric parameters, nutritional status and tumour size. Vincristine (1.50 mg/m(2)) was administered as part of the standard chemotherapy regimen. Vincristine plasma concentrations were measured at several time points by liquid chromatography-mass spectrometry. Vincristine pharmacokinetic parameters (clearance and area under the curve) were calculated by non-compartmental analysis. RESULTS: Eleven Malawian and 8 UK patients were included. Mean Z-score of (corrected) weight for height was significantly lower in the Malawian patients than in the UK patients (-2.3 versus 0.42, p<0.0001). Mean tumour weight at diagnosis was significantly larger in Malawian patients (2.8 kg versus 0.7 kg, p=0.007). Mean vincristine logClearance was lower in Malawian as compared to UK patients (2.2 versus 2.6 ml/min, p=0.001). Mean logAUC values were higher in Malawian than in UK patients (3.8 versus 3.5 microg/mlmin, p=0.003). This difference is reflected in the, on average, 1.98-fold larger vincristine AUC values for Malawian patients. The difference in AUC values was statistically significantly explained by nutritional status (p=0.043). CONCLUSION: Malnourished patients in Malawi exhibited lower vincristine clearance rates and thus higher AUC values than a comparable patient population with a better nutritional status in the UK. In malnourished patients, dose reductions may need to be considered to prevent an increased incidence and severity of toxicity. |
| | |
Authors:
|
Trijn Israels; Carola W N Damen; Michael Cole; Nan van Geloven; Alan V Boddy; Huib N Caron; Jos H Beijnen; Elizabeth M Molyneux; Gareth J Veal |
Related Documents
:
|
11110853 - Poor micronutrient status of active pulmonary tuberculosis patients in indonesia. 12781863 - Nutrition support for the patient with an open abdomen after major abdominal trauma. 20352153 - Acquired von willebrand syndrome in patients with ventricular assist device or total ar... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-09 |
Journal Detail:
|
Title: European journal of cancer (Oxford, England : 1990) Volume: 46 ISSN: 1879-0852 ISO Abbreviation: Eur. J. Cancer Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-06-16 Completed Date: 2010-10-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9005373 Medline TA: Eur J Cancer Country: England |
Other Details:
|
Languages: eng Pagination: 1841-7 Citation Subset: IM |
Copyright Information:
|
Copyright 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
|
Department of Paediatrics, College of Medicine, University of Malawi, Blantyre, Malawi. t.israels@amc.uva.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Antineoplastic Agents, Phytogenic / pharmacokinetics* Area Under Curve Child Female Humans Kidney Neoplasms / complications, drug therapy, metabolism* Malawi Male Malnutrition / complications*, metabolism Metabolic Clearance Rate Vincristine / pharmacokinetics* Wilms Tumor / complications, drug therapy, metabolism* |
| Chemical | |
Reg. No./Substance:
|
0/Antineoplastic Agents, Phytogenic; 57-22-7/Vincristine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Catalogue, cause, complexity and cure; the many uses of cancer genome sequence.
Next Document: Recent advances in the separators for microbial fuel cells.