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Blood, 15 December 2006, Vol. 108, No. 13, pp. 3997-4002.
Prepublished online as a Blood First Edition Paper on August 17, 2006; DOI 10.1182/blood-2006-05-024414.
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Submitted May 22, 2006
Accepted August 8, 2006
Body mass index does not influence pharmacokinetics or outcome of treatment in children with acute lymphoblastic leukemia
Nobuko Hijiya*, John C Panetta, Yinmei Zhou, Emily P Kyzer, Scott C Howard, Sima Jeha, Bassem I Razzouk, Raul C. Ribeiro, Jeffrey E. Rubnitz, Melissa M Hudson, John T Sandlund, Ching-Hon Pui, and Mary V. Relling
St Jude Children's Research Hospital, Memphis, TN, USA
* Corresponding author; email: nobuko.hijiya{at}stjude.org.
There is conflicting information about the influence of body mass index (BMI) on the pharmacokinetics, toxicity, and outcome of chemotherapy. We compared pharmacokinetics, outcome, and toxicity data across four BMI groups (underweight, BMI  10th percentile; normal; at-risk of overweight, BMI  85th and < 95th percentile; overweight, BMI 95th percentile) in 621 children with acute lymphoblastic leukemia (ALL) treated on four consecutive St Jude Total Therapy studies. Chemotherapy doses were not adjusted to ideal BMI. Estimates of overall survival (86.1%± 3.4%, 86.0%± 1.7%, 85.9%&± 4.3%, and 78.2%± 5.5%, P=0.533), event-free survival (76.2%± 4.2%, 78.7%± 2.1%, 73.4%± 5.5%, and 72.7%± 5.9%, P=0.722), and cumulative incidence of relapse (16.0± 3.7%, 14.4%± 1.8%, 20.6%± 5.1%, and 16.7%± 5.1%, P=0.862) did not differ across the four groups. In addition, the intracellular levels of thioguanine nucleotides and methotrexate polyglutamates did not differ between the four BMI groups (p=0.73 and p=0.74, respectively). The four groups also did not differ in the overall incidence of grade 3 or 4 toxicity during the induction or post-induction periods. Further, the systemic clearance of methotrexate, teniposide, etoposide, and cytarabine did not differ with BMI (p>0.3). We conclude that BMI does not affect the outcome or toxicity of chemotherapy in this patient population with ALL.
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[Abstract]
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