1. Slower degradation rate of cytarabine in blood samples from acute myeloid leukemia by comparison with control samples.
- Author
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Abbara C, Drevin G, Férec S, Ghamrawi S, Souchet S, Robin JB, Schmidt A, Hunault-Berger M, Guardiola P, and Briet M
- Subjects
- Adolescent, Adult, Antimetabolites, Antineoplastic administration & dosage, Antimetabolites, Antineoplastic chemistry, Antimetabolites, Antineoplastic isolation & purification, Case-Control Studies, Chromatography, High Pressure Liquid, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Cytarabine administration & dosage, Cytarabine chemistry, Cytarabine isolation & purification, Cytidine Deaminase isolation & purification, Deamination, Drug Stability, Female, Half-Life, Humans, Leukemia, Myeloid, Acute blood, Leukemia, Myeloid, Acute metabolism, Male, Middle Aged, Randomized Controlled Trials as Topic, Specimen Handling, Tandem Mass Spectrometry, Time Factors, Young Adult, Antimetabolites, Antineoplastic blood, Cytarabine blood, Cytidine Deaminase metabolism, Leukemia, Myeloid, Acute drug therapy
- Abstract
Purpose: Cytarabine, a key chemotherapy agent for acute myeloid leukemia (AML) treatment, is deaminated into inactive uracil-arabinoside by cytidine deaminase. This deamination leads to samples stability issues with respect to clinical pharmacokinetic trials. The aim of our study was to study in vitro cytarabine stability in blood samples obtained from AML patients., Methods: Cytarabine quantification was performed using a fully validated LC/MS/MS method. In vitro cytarabine stability was assessed at room temperature over 24 h in samples coming from 14 AML patients and 7 control patients (CTRL) with no hematological malignancy. In vitro concentrations versus time data were analyzed using a noncompartmental approach., Results: Cytarabine in vitro area under the curve (AUC
IVlast ) was 22-fold higher in AML samples as compared to CTRL samples (AML mean (standard deviation (SD)), 51,829 (27,004) h ng/mL; CTRL mean (SD), 2356 (1250) h ng/mL, p = 0.00019). This increase was associated with a prolonged in vitro degradation half-life (t1/2IVdeg AML mean (SD), 15 (11.8) h; CTRL mean (SD), 0.36 (0.37) h, p = 0.0033). Multiple linear regression analysis showed that AML diagnosis significantly influenced t1/2IVdeg and AUCIVlas relationship., Conclusion: Cytarabine stability is higher in AML than in CTRL samples. The absence of correlation between t1/2IVdeg and AUCIVlast in AML samples suggests that in vitro cytarabine degradation in AML is complex. These results open perspectives including the evaluation of the clinical relevance and the involved molecular mechanisms.- Published
- 2020
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