Impact of nutrition on pharmacokinetics of anti-neoplastic agents

Murry, Daryl J.; Riva, Luca; Poplack, David G.

doi:10.1002/(sici)1097-0215(1998)78:11+<48::aid-ijc14>3.0.co;2-3

Cited by 106 publications

(48 citation statements)

References 23 publications

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“…In addition, several previous reports showed that the status of nutrition had an impact on the metabolism of the chemotherapeutic drugs. 29,30 For instance, nutritional status was reported to affect the level of cytochrome P450 enzymes which are responsible for the metabolism of the chemotherapeutic drugs. It was reported that there was a correlation between total body weight and plasma half-life of CY, which means that the concentration of CY is higher in obese patients compared with the normal weight patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoietic SCT

Fuji¹,

Takano²,

Mori

et al. 2014

Bone Marrow Transplant

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To elucidate the impact of pretransplant body mass index (BMI) on the clinical outcome, we performed a retrospective study with registry data including a total of 12 050 patients (age ⩾ 18 years) who received allogeneic hematopoietic SCT (HSCT) between 2000 and 2010. Patients were stratified as follows: BMIo 18.5 kg/m 2 , Underweight, n = 1791; 18.5 ⩽ BMIo 25, Normal, n = 8444; 25 ⩽ BMIo 30, Overweight, n = 1591; BMI ⩾ 30, Obese, n = 224. The median age was 45 years (range, 18-77). A multivariate analysis showed that the risk of relapse was significantly higher in the underweight group and lower in the overweight and obese groups compared with the normal group (hazard ratio (HR), 1.16, 0.86, and 0.74, respectively). The risk of GVHD was significantly higher in the overweight group compared with the normal group. The risk of non-relapse mortality (NRM) was significantly higher in the overweight and obese group compared with the normal group (HR 1.19 and HR 1.43, respectively). The probability of OS was lower in the underweight group compared with the normal group (HR 1.10, P = 0.018). In conclusion, pretransplant BMI affected the risk of relapse and NRM after allogeneic HSCT. Underweight was a risk factor for poor OS because of an increased risk of relapse. Obesity was a risk factor for NRM.

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Section: Discussionmentioning

confidence: 99%

Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoietic SCT

Fuji¹,

Takano²,

Mori

et al. 2014

Bone Marrow Transplant

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“…It is unknown what determines this influence of baseline weight on relapse occurrence. It is conceivable that several factors may be involved, including impaired immune function, reduced absorption of treatment medication, and decreased drug-protein binding, 34,35 which are all in general determined by genetic variation. Patients who were underweight at diagnosis in our study showed a low lean body mass as well as a low %fat compared to normal or overweight patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who were underweight at diagnosis in our study showed a low lean body mass as well as a low %fat compared to normal or overweight patients. All these factors might produce variations in drug pharmacokinetics; 34 however, the impact of weight status on pharmacokinetics and pharmacodynamics remains under debate in pediatric oncology as there are conflicting reports. 5,36 In the current study underweight patients had a higher incidence of relapse, but interestingly, did not experience many (toxic) events as the event-free survival was similar for both BMI groups (underweight or not underweight).…”

Section: Discussionmentioning

confidence: 99%

“…24,25,27 Change of BMI was measured between diagnosis and 32 weeks of treatment (T0 to T1), and between diagnosis and cessation of antileukemic treatment (T0 to T2). Patients were included in the analysis if BMI was measured at 32 weeks (range, [30][31][32][33][34][35][36][37][38][39][40] or at 109 weeks (range, 104-114). BMI change was analyzed into categories: BMI SDS loss or BMI SDS gain.…”

Section: Body Compositionmentioning

confidence: 99%

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The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia

et al. 2014

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Correspondence: m.vandenheuvel@erasmusmc.nlBody mass index and change in body mass index during treatment may influence treatment outcome of pediatric patients with acute lymphoblastic leukemia. However, previous studies in pediatric acute lymphoblastic leukemia reported contradictory results. We prospectively collected data on body composition from a cohort of newly diagnosed Dutch pediatric patients with acute lymphoblastic leukemia (n=762, age 2-17 years). Patients were treated from 1997-2004 and the median follow-up was 9 years (range, 0-10). Body mass index at diagnosis was expressed as age-and gender-matched standard deviation scores and on the basis of these scores the patients were categorized as being underweight, of normal weight or overweight. Multivariate analyses showed that patients who were underweight (8%) had a higher risk of relapse [hazard ratio: 1.88, 95% confidence interval (1.13-3.13)], but similar overall survival and event-free survival as patients who had a normal weight or who were overweight. Patients with loss of body mass index during the first 32 weeks of treatment had a similar risk of relapse and eventfree survival, but decreased overall survival [hazard ratio: 2.10, 95% confidence interval (1.14-3.87)] compared to patients without a loss of body mass index. In addition, dual X-ray absorptiometry scans were performed in a nested, single-center cohort. Data from these scans revealed that a loss of body mass consisted mainly of a loss of lean body mass, while there was a gain in the percentage of fat. In conclusion, being underweight at diagnosis is a risk factor for relapse, and a decrease in body mass index early during treatment is associated with decreased survival. In addition, loss of body mass during treatment seems to consist mainly of a loss of lean body mass. This study was approved by the Medical Ethical Committee in 1996 (trial number NTR460/SNWLK-ALL-9). The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia ABSTRACT Methods Study populationThis study included newly diagnosed pediatric ALL patients, aged 2-17 years, treated according to the Dutch Childhood Oncology Group (DCOG) -ALL9 protocol, between January 1997 and November 2004 in seven pediatric oncology centers in the Netherlands. 21 The patients were stratified at diagnosis into nonhigh-risk and high-risk treatment groups as previously described.21

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“…Las Guías Clínicas de la Sociedad Europea de Nutrición Clínica y Metabolismo (ESPEN) recomiendan el Nutritional Risk Sreening (NRS 2002), para evaluación nutricional de pacientes hospitalizados, sin embargo, éste aún no ha sido validado en cohortes de pacientes con enfermedad neoplásica avanzada. Tanto la evaluación global subjetiva (EGS) como la EGS generada por el paciente (EGS GP) 22 no incluyen datos objetivos y cuantificables, pero son herramientas válidas en la evaluación de los pacientes con cán-cer [23][24][25][26][27][28] y se correlacionan bien con los métodos clásicos, constituyendo excelentes indicadores de pronóstico 29 .…”

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Relación entre estado nutricional y evolución postoperatoria, en cirugía oncológica digestiva

Pañella

Jara

Cornejo³

et al. 2014

Rev. méd. Chile

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Impact of nutrition on pharmacokinetics of anti-neoplastic agents

Cited by 106 publications

References 23 publications

Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoietic SCT

Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoietic SCT

The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia

Relación entre estado nutricional y evolución postoperatoria, en cirugía oncológica digestiva

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