Conventional Compared with Individualized Chemotherapy for Childhood Acute Lymphoblastic Leukemia

• Published in: The New England journal of medicine Vol. 338; no. 8; pp. 499 - 505
• Main Authors: Evans, William E, Relling, Mary V, Rodman, John H, Crom, William R, Boyett, James M, Pui, Ching-Hon
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 19-02-1998
• Subjects: Adolescent; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - pharmacokinetics; Biological and medical sciences; Chemotherapy; Child; Child, Preschool; Cytarabine - administration & dosage; Cytarabine - pharmacokinetics; Deoxyribonucleic acid; DNA; Drug dosages; Drug therapy; Female; Humans; Infant; Leukemia; Leukemia, B-Cell - drug therapy; Male; Medical sciences; Metabolic Clearance Rate; Methotrexate - administration & dosage; Methotrexate - pharmacokinetics; Patient Care Planning; Patients; Pharmacology. Drug treatments; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Proportional Hazards Models; Prospective Studies; Remission Induction; Survival Analysis; Teniposide - administration & dosage; Teniposide - pharmacokinetics; Antineoplastic agent; Human; Evaluation; Acute; Malignant hemopathy; Antifolate; Randomization; Antimetabolic; Lymphoproliferative syndrome; Effective dose; Acute lymphocytic leukemia; Methotrexate; Pharmacokinetics; Therapeutic protocol; Child
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199802193380803

Childhood acute lymphoblastic leukemia is curable in approximately 70 percent of children.
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,
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Many of the children who are not cured have presenting features that are indistinguishable from those in children who are cured. We reasoned that because systemic clearance of anticancer drugs differs by a factor of 3 to 10 among patients,
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those with rapid drug clearance may benefit less than those with slower clearance if the dose is determined only according to body-surface area. This hypothesis was based in part on our finding that the outcome was significantly worse among children with acute lymphoblastic leukemia who had low . . .