Prognostic relevance of clinical pharmacology of antileukemic drugs

Abstract

Response to treatment is the most important prognostic factor in children undergoing treatment for acute lymphoblastic leukemia. Factors that interfere with the pharmacokinetic determinants of anti-leukemic compounds may cause a decreased activity of one or more of the drugs included in the treatment protocol. Noncompliance with the prescribed treatment, individual pharmacokinetic differences, interference with oral drug absorption, and different guidelines for dose reduction related to toxicity are some of the factors responsible for a decreased or variable antileukemic activity which may influence treatment results.

Association of delivered drug dose and outcome for children with acute lymphoblastic leukemia and unfavorable presenting features

“…Protocol compliance may convey a nonspecific benefit even when the therapy employed is no more than placebo [27]. In this study, a trend is apparent in favor of patients for whom complete dose data were available, but the advantage is less striking than the advantage for patients who received full protocol dose of vincristine and/or anthracycline.…”