Journal article
Comparison of self-report and electronic monitoring of 6MP intake in childhood ALL: a Children's Oncology Group study
Blood, Vol.129(14), pp.1919-1926
04/06/2017
DOI: 10.1182/blood-2016-07-726893
PMCID: PMC5383868
PMID: 28153823
Abstract
Adequate exposure to oral 6-mercaptopurine (6MP) during maintenance therapy for childhood acute lymphoblastic leukemia (ALL) is critical for sustaining durable remissions; accuracy of self-reported 6MP intake is unknown. We aimed to directly compare self-report to electronic monitoring (Medication Event Monitoring System [MEMS]) and identify predictors of overreporting in a cohort of 416 children with ALL in first remission over 4 study months (1344 patient-months for the cohort) during maintenance therapy. Patients were classified as "perfect reporters" (self-report agreed with MEMS), "overreporters" (self-report was higher than MEMS by ≥5 days/month for ≥50% of study months), and "others" (not meeting criteria for perfect reporter or overreporter). Multivariable logistic regression examined sociodemographic and clinical characteristics, 6MP dose intensity,
genotype, thioguanine nucleotide levels, and 6MP nonadherence (MEMS-based adherence <95%) associated with the overreporter phenotype; generalized estimating equations compared 6MP intake by self-report and MEMS. Self-reported 6MP intake exceeded MEMS at least some of the time in 84% of patients. Fifty patients (12%) were classified as perfect reporters, 98 (23.6%) as overreporters, 2 (0.5%) as underreporters, and 266 (63.9%) as others. In multivariable analysis, the following variables were associated with the overreporter phenotype: non-white race: Hispanic, odds ratio (OR), 2.4,
= .02; Asian, OR, 3.1,
= .02; African American,
< .001; paternal education less than college (OR, 1.4,
= .05); and 6MP nonadherence (OR, 9.4,
< .001). Self-report of 6MP intake in childhood ALL overestimates true intake, particularly in nonadherent patients, and should be used with caution.
Details
- Title: Subtitle
- Comparison of self-report and electronic monitoring of 6MP intake in childhood ALL: a Children's Oncology Group study
- Creators
- Wendy Landier - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, ALYanjun Chen - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, ALLindsey Hageman - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, ALHeeyoung Kim - Department of Population Sciences, City of Hope, Duarte, CABruce C Bostrom - Department of Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MNJacqueline N Casillas - Department of Pediatrics, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, CADavid S Dickens - Division of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital at Spectrum Health/Spectrum Health at Butterworth Campus, Grand Rapids, MIWilliam E Evans - Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TNKelly W Maloney - Department of Pediatrics, University of Colorado School of Medicine, Aurora, COLeo Mascarenhas - Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CAA Kim Ritchey - Department of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA; andAmanda M Termuhlen - Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CAWilliam L Carroll - Department of Pediatrics, Perlmutter Cancer Center, New York University-Langone Medical Center, New York, NYMary V Relling - Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TNF Lennie Wong - Department of Population Sciences, City of Hope, Duarte, CASmita Bhatia - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.129(14), pp.1919-1926
- DOI
- 10.1182/blood-2016-07-726893
- PMID
- 28153823
- PMCID
- PMC5383868
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Grant note
- U10 CA098413 / NCI NIH HHS U10 CA180886 / NCI NIH HHS U10 CA095861 / NCI NIH HHS R01 CA096670 / NCI NIH HHS UG1 CA189955 / NCI NIH HHS P30 CA021765 / NCI NIH HHS U10 CA180899 / NCI NIH HHS P50 GM115279 / NIGMS NIH HHS U10 CA098543 / NCI NIH HHS
- Language
- English
- Date published
- 04/06/2017
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984093358502771
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