The role of purine analogue combinations in the management of acute leukemias.
Cytosine arabinoside plays a pivotal role in the therapy of acute myeloid leukemias with the concentration of its active metabolite, ara-CTP, being positively correlated with improved clinical outcome. Both in vitro studies and ex vivo studies have confirmed the ability of the purine analogues to enhance ara-CTP accumulation within leukemic cells via the stimulation of deoxycytidine kinase. Clinical studies have confirmed the efficacy of these combination regimes in the treatment of acute leukemias. The basis of the biochemical rationale for the development of combination chemotherapy regimes with purine analogues for acute leukemias is reviewed along with clinical studies of their effectiveness and toxicity.
Frewin
R J
RJ
Taunton and Somerset NHS Trust, Taunton, Somerset, UK. frewin@dialstart.net
Johnson
S A
SA
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D003561:Cytarabine / Q000494:pharmacology / Q000627:therapeutic use*; D004357:Drug Synergism; D006801:Humans; D007938:Leukemia / Q000188:drug therapy*; D011687:Purines / Q000494:pharmacology / Q000627:therapeutic use*
D011687:Purines; D003561:Cytarabine