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Doxorubicin Pharmacokinetics and Response in Non Hodgkin's Lymphoma

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Meir Medical Center

关键词

抽象

In previous studies, the investigators found that in patients with Hodgkin's lymphoma (HL) treated with ABVD (adriamycin, bleomycin, vinblastine and decarbazine) the absence of alopecia may predict for a poor response to treatment [complete remission (CR) rate 79% versus 31%, P < 0.0005, respectively]. Also, patients without alopecia had fewer episodes of either leucopenia, neutropenia, deferral of treatment courses or number of courses with dose reduction [88% vs. 62.5%, P=0.05, for the presence of at least one of them].
One of the explanations for this phenomenon is related to a lower systemic exposure of chemotherapeutic drugs in patients who retain their hair. There is a wide interpatient variability in the pharmacokinetic and pharmacodynamic parameters of doxorubicin systemic exposure and the degree of myelosuppression.
In a pilot study on 18 patients the investigators could not find the previous association between alopecia, response to chemotherapy and bone marrow depression. However, when analyzing doxorubicin pharmacokinetics, patients who had no remission had 2 fold lower AUC (area under the curve) and 3 fold lower peaks (p=0.06). The investigators' lack to approve the previous findings might be explained by the small study group.

描述

Aim of the study:

To evaluate the association between response to chemotherapy, the degree of myelosuppression and the pharmacokinetics of doxorubicin in non-Hodgkin's lymphoma (NHL) patients.

Methods:

Study protocol:

1. At diagnosis

Demographic and clinical parameters be collected (Appendix 1)

2. At course 2:

1. Doxorubicin will be given by 5-7 minutes infusion before the other medications (Doxorubicin doses will be collected (Appendix 1))

2. Blood will be sampled in course 2, at:

0 minutes 30 minutes 120 minutes 24 hours

Two 2ml EDT tubes will be drawn at each time The tubes will be centrifuged at 3000 RPM for 15 min. Plasma samples will be stored in - 700C

3. At the end of chemotherapy courses the following data will be collected (Appendix 2):

1. Episodes of bone marrow depression (leucopenia, neutropenia) Treatment delays Dose reductions Neutropenic fever

2. Remission status

[Complete remission (CR) - disappearance of clinical signs and symptoms of NHL along with normal laboratory and radiological findings].

4. At the end of one year of CR

Remission status

Number of patients: 30

日期

最后验证: 02/29/2012
首次提交: 08/16/2009
提交的预估入学人数: 08/30/2009
首次发布: 08/31/2009
上次提交的更新: 06/26/2013
最近更新发布: 06/30/2013
实际学习开始日期: 08/31/2009
预计主要完成日期: 11/30/2011
预计完成日期: 11/30/2012

状况或疾病

Non-Hodgkin's Lymphoma

干预/治疗

Drug: Doxorubicin

相 4

手臂组

干预/治疗
No Intervention: Doxorubicin
Single arm
Drug: Doxorubicin
measurements of serum Doxorubicin levels

资格标准

有资格学习的年龄 18 Years 至 18 Years
有资格学习的性别All
接受健康志愿者
标准

Inclusion Criteria:

- Age ≥ 18 years

- Biopsy proven intermediate grade NHL

- No previous chemotherapy

- At least 4 courses of R-CHOP at maximal doses are planned

- An informed consent

Exclusion Criteria:

- Do not meet all inclusion criteria

结果

主要结果指标

1. Doxorubicin, pharmacokinetics at first chemotherapy course [1 year]

次要成果指标

1. Association between doxorubicin pharmacokinetics and response [1 year]

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