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Use of allopurinol in children with acute lymphoblastic leukemia to reduce skewed thiopurine metabolism
Author(s) -
Brackett Julienne,
Schafer Eric S.,
Leung Daniel H.,
Bernhardt M. Brooke
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24913
Subject(s) - medicine , allopurinol , thiopurine methyltransferase , mercaptopurine , lymphoblastic leukemia , leukemia , gastroenterology , pharmacology , disease , inflammatory bowel disease
Mercaptopurine (6‐MP), a critical component of acute lymphoblastic leukemia (ALL) therapy, is metabolized to 6‐thioguanine (6‐TGN) which is responsible for its anti‐leukemic effect, and to 6‐methylmercaptopurine nucleotides (6‐MMPN/6‐MMP) which can be hepatotoxic. Some patients preferentially metabolize 6‐MP to 6‐MMPN which may increase the risk of liver injury, reduce serum levels of 6‐TGN and potentially increase the risk of relapse. The addition of allopurinol to oral 6‐MP has been shown to optimize metabolism towards 6‐TGN in patients with inflammatory bowel disease (IBD); however, this use has not been reported in patients undergoing treatment for ALL. Pediatr Blood Cancer 2014;61:1114–1117. © 2013 Wiley Periodicals, Inc.