No evidence that G6PD deficiency affects the efficacy or safety of daunorubicin in acute lymphoblastic leukemia induction therapy

Background/Objectives Anthracyclines are used in induction therapy of pediatric acute lymphoblastic leukemia (ALL) and are known to generate oxidative stress; whether this translates into enhanced antileukemic activity or hemolytic effects in patients with glucose‐6‐phosphate dehydrogenase (G6PD) de...

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Veröffentlicht in:Pediatric blood & cancer 2019-06, Vol.66 (6), p.e27681-n/a
Hauptverfasser: Robinson, Katherine M., Yang, Wenjian, Karol, Seth E., Kornegay, Nancy, Jay, Dennis, Cheng, Cheng, Choi, John K., Campana, Dario, Pui, Ching‐Hon, Wood, Brent, Borowitz, Michael J., Gastier‐Foster, Julie, Larsen, Eric C., Winick, Naomi, Carroll, William L., Loh, Mignon L., Raetz, Elizabeth A., Hunger, Stephen P., Devidas, Meenakshi, Mardis, Elaine R., Fulton, Robert S., Relling, Mary V., Jeha, Sima
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container_end_page n/a
container_issue 6
container_start_page e27681
container_title Pediatric blood & cancer
container_volume 66
creator Robinson, Katherine M.
Yang, Wenjian
Karol, Seth E.
Kornegay, Nancy
Jay, Dennis
Cheng, Cheng
Choi, John K.
Campana, Dario
Pui, Ching‐Hon
Wood, Brent
Borowitz, Michael J.
Gastier‐Foster, Julie
Larsen, Eric C.
Winick, Naomi
Carroll, William L.
Loh, Mignon L.
Raetz, Elizabeth A.
Hunger, Stephen P.
Devidas, Meenakshi
Mardis, Elaine R.
Fulton, Robert S.
Relling, Mary V.
Jeha, Sima
description Background/Objectives Anthracyclines are used in induction therapy of pediatric acute lymphoblastic leukemia (ALL) and are known to generate oxidative stress; whether this translates into enhanced antileukemic activity or hemolytic effects in patients with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is unknown. Design/Methods Among 726 pediatric patients with newly diagnosed ALL treated at St. Jude Children's Research Hospital, 22 had deficient G6PD activity. We compared the prevalence of positive minimal residual disease (MRD) ≥1% at Day 15/Day 19 of induction or ≥0.01% at Day 42/Day 46 (end of induction) and the number of red blood cell (RBC) transfusions after daunorubicin in induction between patients with or without G6PD deficiency, adjusting for ALL risk group, treatment protocol, age, and gender. Results There was no difference in Day 15/19 (P = 1) or end of induction MRD (P = 0.76) nor in the number of RBC transfusions (P = 0.73); the lack of association with MRD was confirmed in a dataset of 1192 newly diagnosed male patients enrolled in a Children's Oncology Group trial (P = 0.78). Conclusion We found no evidence that G6PD deficiency affects daunorubicin activity during induction treatment for ALL.
doi_str_mv 10.1002/pbc.27681
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Design/Methods Among 726 pediatric patients with newly diagnosed ALL treated at St. Jude Children's Research Hospital, 22 had deficient G6PD activity. We compared the prevalence of positive minimal residual disease (MRD) ≥1% at Day 15/Day 19 of induction or ≥0.01% at Day 42/Day 46 (end of induction) and the number of red blood cell (RBC) transfusions after daunorubicin in induction between patients with or without G6PD deficiency, adjusting for ALL risk group, treatment protocol, age, and gender. Results There was no difference in Day 15/19 (P = 1) or end of induction MRD (P = 0.76) nor in the number of RBC transfusions (P = 0.73); the lack of association with MRD was confirmed in a dataset of 1192 newly diagnosed male patients enrolled in a Children's Oncology Group trial (P = 0.78). Conclusion We found no evidence that G6PD deficiency affects daunorubicin activity during induction treatment for ALL.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.27681</identifier><identifier>PMID: 30848065</identifier><language>eng</language><publisher>United States</publisher><subject>Antibiotics, Antineoplastic - therapeutic use ; Child ; Cohort Studies ; daunorubicin ; Daunorubicin - therapeutic use ; doxorubicin ; Female ; Follow-Up Studies ; Glucosephosphate Dehydrogenase - metabolism ; glucose‐6‐phospate dehydrogenase ; Humans ; Induction Chemotherapy ; leukemia ; Male ; Neoadjuvant Therapy ; Neoplasm, Residual - drug therapy ; Neoplasm, Residual - enzymology ; Neoplasm, Residual - pathology ; pharmacogenetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - enzymology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology ; Prognosis ; Risk Factors ; Safety</subject><ispartof>Pediatric blood &amp; cancer, 2019-06, Vol.66 (6), p.e27681-n/a</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4151-87fa985b8ed4110676fa7b0580944594765efd188d37393b073c477664ef0dd53</citedby><cites>FETCH-LOGICAL-c4151-87fa985b8ed4110676fa7b0580944594765efd188d37393b073c477664ef0dd53</cites><orcidid>0000-0003-1550-4167 ; 0000-0002-3720-9591 ; 0000-0003-0303-5658</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.27681$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.27681$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30848065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Robinson, Katherine M.</creatorcontrib><creatorcontrib>Yang, Wenjian</creatorcontrib><creatorcontrib>Karol, Seth E.</creatorcontrib><creatorcontrib>Kornegay, Nancy</creatorcontrib><creatorcontrib>Jay, Dennis</creatorcontrib><creatorcontrib>Cheng, Cheng</creatorcontrib><creatorcontrib>Choi, John K.</creatorcontrib><creatorcontrib>Campana, Dario</creatorcontrib><creatorcontrib>Pui, Ching‐Hon</creatorcontrib><creatorcontrib>Wood, Brent</creatorcontrib><creatorcontrib>Borowitz, Michael J.</creatorcontrib><creatorcontrib>Gastier‐Foster, Julie</creatorcontrib><creatorcontrib>Larsen, Eric C.</creatorcontrib><creatorcontrib>Winick, Naomi</creatorcontrib><creatorcontrib>Carroll, William L.</creatorcontrib><creatorcontrib>Loh, Mignon L.</creatorcontrib><creatorcontrib>Raetz, Elizabeth A.</creatorcontrib><creatorcontrib>Hunger, Stephen P.</creatorcontrib><creatorcontrib>Devidas, Meenakshi</creatorcontrib><creatorcontrib>Mardis, Elaine R.</creatorcontrib><creatorcontrib>Fulton, Robert S.</creatorcontrib><creatorcontrib>Relling, Mary V.</creatorcontrib><creatorcontrib>Jeha, Sima</creatorcontrib><title>No evidence that G6PD deficiency affects the efficacy or safety of daunorubicin in acute lymphoblastic leukemia induction therapy</title><title>Pediatric blood &amp; cancer</title><addtitle>Pediatr Blood Cancer</addtitle><description>Background/Objectives Anthracyclines are used in induction therapy of pediatric acute lymphoblastic leukemia (ALL) and are known to generate oxidative stress; whether this translates into enhanced antileukemic activity or hemolytic effects in patients with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is unknown. Design/Methods Among 726 pediatric patients with newly diagnosed ALL treated at St. Jude Children's Research Hospital, 22 had deficient G6PD activity. We compared the prevalence of positive minimal residual disease (MRD) ≥1% at Day 15/Day 19 of induction or ≥0.01% at Day 42/Day 46 (end of induction) and the number of red blood cell (RBC) transfusions after daunorubicin in induction between patients with or without G6PD deficiency, adjusting for ALL risk group, treatment protocol, age, and gender. Results There was no difference in Day 15/19 (P = 1) or end of induction MRD (P = 0.76) nor in the number of RBC transfusions (P = 0.73); the lack of association with MRD was confirmed in a dataset of 1192 newly diagnosed male patients enrolled in a Children's Oncology Group trial (P = 0.78). Conclusion We found no evidence that G6PD deficiency affects daunorubicin activity during induction treatment for ALL.</description><subject>Antibiotics, Antineoplastic - therapeutic use</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>daunorubicin</subject><subject>Daunorubicin - therapeutic use</subject><subject>doxorubicin</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucosephosphate Dehydrogenase - metabolism</subject><subject>glucose‐6‐phospate dehydrogenase</subject><subject>Humans</subject><subject>Induction Chemotherapy</subject><subject>leukemia</subject><subject>Male</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm, Residual - drug therapy</subject><subject>Neoplasm, Residual - enzymology</subject><subject>Neoplasm, Residual - pathology</subject><subject>pharmacogenetics</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - enzymology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Safety</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1vFSEYhYmxsR-68A8Ylrq4LdzhazYm9trWJo12oWvCwIsXnRlGYGpm2X8u9dYbXZiQ8OachwPkIPSSklNKyPps6uzpWgpFn6AjyhlfcULl0_1M2kN0nPO3igrC1TN02BDFFBH8CN1_jBjugoPRAi5bU_CVuH2PHfhgQxUXbLwHW3I1AYOvsqliTDgbD6VOHjszjzHNXT0x4rqMnQvgfhmmbex6k0uwuIf5OwzBVN_NtoQ4PgQmMy3P0YE3fYYXj_sJ-nJ58XnzYXXz6ep68-5mZRnldKWkN63inQLHKCVCCm9kV79DWsZ4y6Tg4B1VyjWyaZuOyMYyKYVg4IlzvDlBb3e509wN4CyMJZleTykMJi06mqD_dcaw1V_jnRacKkbXNeD1Y0CKP2bIRQ8hW-h7M0Kcs15T1fKGMq4q-maH2hRzTuD311CiHyrTtTL9u7LKvvr7XXvyT0cVONsBP0MPy_-T9O35Zhf5C07Iolw</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Robinson, Katherine M.</creator><creator>Yang, Wenjian</creator><creator>Karol, Seth E.</creator><creator>Kornegay, Nancy</creator><creator>Jay, Dennis</creator><creator>Cheng, Cheng</creator><creator>Choi, John K.</creator><creator>Campana, Dario</creator><creator>Pui, Ching‐Hon</creator><creator>Wood, Brent</creator><creator>Borowitz, Michael J.</creator><creator>Gastier‐Foster, Julie</creator><creator>Larsen, Eric C.</creator><creator>Winick, Naomi</creator><creator>Carroll, William L.</creator><creator>Loh, Mignon L.</creator><creator>Raetz, Elizabeth A.</creator><creator>Hunger, Stephen P.</creator><creator>Devidas, Meenakshi</creator><creator>Mardis, Elaine R.</creator><creator>Fulton, Robert S.</creator><creator>Relling, Mary V.</creator><creator>Jeha, Sima</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1550-4167</orcidid><orcidid>https://orcid.org/0000-0002-3720-9591</orcidid><orcidid>https://orcid.org/0000-0003-0303-5658</orcidid></search><sort><creationdate>201906</creationdate><title>No evidence that G6PD deficiency affects the efficacy or safety of daunorubicin in acute lymphoblastic leukemia induction therapy</title><author>Robinson, Katherine M. ; Yang, Wenjian ; Karol, Seth E. ; Kornegay, Nancy ; Jay, Dennis ; Cheng, Cheng ; Choi, John K. ; Campana, Dario ; Pui, Ching‐Hon ; Wood, Brent ; Borowitz, Michael J. ; Gastier‐Foster, Julie ; Larsen, Eric C. ; Winick, Naomi ; Carroll, William L. ; Loh, Mignon L. ; Raetz, Elizabeth A. ; Hunger, Stephen P. ; Devidas, Meenakshi ; Mardis, Elaine R. ; Fulton, Robert S. ; Relling, Mary V. ; Jeha, Sima</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4151-87fa985b8ed4110676fa7b0580944594765efd188d37393b073c477664ef0dd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Antibiotics, Antineoplastic - therapeutic use</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>daunorubicin</topic><topic>Daunorubicin - therapeutic use</topic><topic>doxorubicin</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glucosephosphate Dehydrogenase - metabolism</topic><topic>glucose‐6‐phospate dehydrogenase</topic><topic>Humans</topic><topic>Induction Chemotherapy</topic><topic>leukemia</topic><topic>Male</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm, Residual - drug therapy</topic><topic>Neoplasm, Residual - enzymology</topic><topic>Neoplasm, Residual - pathology</topic><topic>pharmacogenetics</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - enzymology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Safety</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Robinson, Katherine M.</creatorcontrib><creatorcontrib>Yang, Wenjian</creatorcontrib><creatorcontrib>Karol, Seth E.</creatorcontrib><creatorcontrib>Kornegay, Nancy</creatorcontrib><creatorcontrib>Jay, Dennis</creatorcontrib><creatorcontrib>Cheng, Cheng</creatorcontrib><creatorcontrib>Choi, John K.</creatorcontrib><creatorcontrib>Campana, Dario</creatorcontrib><creatorcontrib>Pui, Ching‐Hon</creatorcontrib><creatorcontrib>Wood, Brent</creatorcontrib><creatorcontrib>Borowitz, Michael J.</creatorcontrib><creatorcontrib>Gastier‐Foster, Julie</creatorcontrib><creatorcontrib>Larsen, Eric C.</creatorcontrib><creatorcontrib>Winick, Naomi</creatorcontrib><creatorcontrib>Carroll, William L.</creatorcontrib><creatorcontrib>Loh, Mignon L.</creatorcontrib><creatorcontrib>Raetz, Elizabeth A.</creatorcontrib><creatorcontrib>Hunger, Stephen P.</creatorcontrib><creatorcontrib>Devidas, Meenakshi</creatorcontrib><creatorcontrib>Mardis, Elaine R.</creatorcontrib><creatorcontrib>Fulton, Robert S.</creatorcontrib><creatorcontrib>Relling, Mary V.</creatorcontrib><creatorcontrib>Jeha, Sima</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric blood &amp; cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Robinson, Katherine M.</au><au>Yang, Wenjian</au><au>Karol, Seth E.</au><au>Kornegay, Nancy</au><au>Jay, Dennis</au><au>Cheng, Cheng</au><au>Choi, John K.</au><au>Campana, Dario</au><au>Pui, Ching‐Hon</au><au>Wood, Brent</au><au>Borowitz, Michael J.</au><au>Gastier‐Foster, Julie</au><au>Larsen, Eric C.</au><au>Winick, Naomi</au><au>Carroll, William L.</au><au>Loh, Mignon L.</au><au>Raetz, Elizabeth A.</au><au>Hunger, Stephen P.</au><au>Devidas, Meenakshi</au><au>Mardis, Elaine R.</au><au>Fulton, Robert S.</au><au>Relling, Mary V.</au><au>Jeha, Sima</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>No evidence that G6PD deficiency affects the efficacy or safety of daunorubicin in acute lymphoblastic leukemia induction therapy</atitle><jtitle>Pediatric blood &amp; cancer</jtitle><addtitle>Pediatr Blood Cancer</addtitle><date>2019-06</date><risdate>2019</risdate><volume>66</volume><issue>6</issue><spage>e27681</spage><epage>n/a</epage><pages>e27681-n/a</pages><issn>1545-5009</issn><eissn>1545-5017</eissn><abstract>Background/Objectives Anthracyclines are used in induction therapy of pediatric acute lymphoblastic leukemia (ALL) and are known to generate oxidative stress; whether this translates into enhanced antileukemic activity or hemolytic effects in patients with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is unknown. Design/Methods Among 726 pediatric patients with newly diagnosed ALL treated at St. Jude Children's Research Hospital, 22 had deficient G6PD activity. We compared the prevalence of positive minimal residual disease (MRD) ≥1% at Day 15/Day 19 of induction or ≥0.01% at Day 42/Day 46 (end of induction) and the number of red blood cell (RBC) transfusions after daunorubicin in induction between patients with or without G6PD deficiency, adjusting for ALL risk group, treatment protocol, age, and gender. Results There was no difference in Day 15/19 (P = 1) or end of induction MRD (P = 0.76) nor in the number of RBC transfusions (P = 0.73); the lack of association with MRD was confirmed in a dataset of 1192 newly diagnosed male patients enrolled in a Children's Oncology Group trial (P = 0.78). Conclusion We found no evidence that G6PD deficiency affects daunorubicin activity during induction treatment for ALL.</abstract><cop>United States</cop><pmid>30848065</pmid><doi>10.1002/pbc.27681</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1550-4167</orcidid><orcidid>https://orcid.org/0000-0002-3720-9591</orcidid><orcidid>https://orcid.org/0000-0003-0303-5658</orcidid><oa>free_for_read</oa></addata></record>
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subjects Antibiotics, Antineoplastic - therapeutic use
Child
Cohort Studies
daunorubicin
Daunorubicin - therapeutic use
doxorubicin
Female
Follow-Up Studies
Glucosephosphate Dehydrogenase - metabolism
glucose‐6‐phospate dehydrogenase
Humans
Induction Chemotherapy
leukemia
Male
Neoadjuvant Therapy
Neoplasm, Residual - drug therapy
Neoplasm, Residual - enzymology
Neoplasm, Residual - pathology
pharmacogenetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - enzymology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
Prognosis
Risk Factors
Safety
title No evidence that G6PD deficiency affects the efficacy or safety of daunorubicin in acute lymphoblastic leukemia induction therapy
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