ALLOPURINOL USE DURING MAINTENANCE THERAPY FOR ACUTE LYMPHOBLASTIC LEUKEMIA AVOIDS MERCAPTOPURINE RELATED HEPATOTOXICITY
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY(2014)
摘要
6-Mercaptopurine (6-MP) is the mainstay of treatment for acute lymphoblastic leukemia and lymphoblastic lymphoma. It is metabolized into the pharmacologically active, 6-thioguanine nucleotide (6-TGN), and 6-methyl mercaptopurine nucleotides (6-MMPN), which is associated with hepatotoxicity that jeopardizes antileukemic therapy. Allopurinol alters the metabolism of 6-MP to increase 6-TGN levels and decreases 6-methyl mercaptopurine nucleotides levels. We report 2 cases in which combination therapy of allopurinol with 6-MP was used successfully to avoid hepatotoxicity while delivering adequate 6-TGN levels. We suggest that this combination therapy can be used safely to change the metabolite production in patients who develop excessive hepatotoxicity.
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关键词
hepatotoxicity,allopurinol,pharmacogenetics,acute lymphoblastic leukemia,6-mercaptopurine
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