title: Individualized toxicity-titrated 6-mercaptopurine increments during high-dose methotrexate consolidation treatment of lower risk childhood acute lymphoblastic leukaemia. A Nordic Society of Paediatric Haematology and Oncology (NOPHO) pilot study.
abstract: This study explored the feasibility and toxicity of individualized toxicity-titrated 6-mercaptopurine (6MP) dose increments during post-remission treatment with High-dose methotrexate (HDM) (5000 mg/m(2), ×3) in 38 patients with Childhood (ALL). Patients were increased in steps of 25 mg 6MP/m(2) 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/m(2) per day had significantly shorter duration of treatment interruptions of 6MP than the remaining patients (P = 0·03). This study shows individualized toxicity-titrated 6MP dosing during consolidation is feasible without increased risk of toxicity.
authors.affiliation: Department of Paediatrics, Rigshospitalet, Copenhagen, Denmark. tlf@rh.regionh.dk
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Frandsen
authors.forename: Jonas
authors.initials: J
authors.lastname: Abrahamsson
authors.forename: Birgitte
authors.initials: B
authors.lastname: Lausen
authors.forename: Kim
authors.initials: K
authors.lastname: Vettenranta
authors.forename: Mats
authors.initials: M
authors.lastname: Heyman
authors.forename: Michael
authors.initials: M
authors.lastname: Behrentz
authors.forename: Anders
authors.initials: A
authors.lastname: Castor
authors.forename: Peder S
authors.initials: PS
authors.lastname: Wehner
authors.forename: Britt-marie
authors.initials: BM
authors.lastname: Frost
authors.forename: Elisabeth W
authors.initials: EW
authors.lastname: Andersen
authors.forename: Kjeld
authors.initials: K
authors.lastname: Schmiegelow
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007223:Infant; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage* / Q000009:adverse effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D052016:Mucositis / Q000139:chemically induced; D010195:Pancreatitis / Q000139:chemically induced; D010865:Pilot Projects; D057285:Precision Medicine; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D015122:Mercaptopurine; D008727:Methotrexate