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Individualized toxicity-titrated 6-mercaptopurine increments during high-dose methotrexate consolidation treatment of lower risk childhood acute lymphoblastic leukemia. A Nordic Society of Pediatric Hematology and Oncology (NOPHO) pilot study
British Journal of Haematology, 08/24/2011
Clinical Article
Frandsen TL et al. – This study shows individualized toxicity–titrated 6MP dosing during consolidation is feasible without increased risk of toxicity.
Methods- Explored feasibility and toxicity of individualized toxicity–titrated 6–mercaptopurine (6MP) dose increments during post–remission treatment with High–dose methotrexate (HDM) (5000 mg/m2, ×3) in 38 patients with Childhood (ALL)
- Patients were increased in steps of 25 mg 6MP/m2 per day if they did not develop myelotoxicity within 2 weeks after HDM
- 6MP could be increased in 31 patients (81%)
- Toxicity was acceptable and did not differ significantly between groups
- Patients receiving 75 mg/m2 per day had significantly shorter duration of treatment interruptions of 6MP than the remaining patients (P = 0·03)