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

• Published in: British journal of haematology 2011-10, Vol.155 (2), p.244-247
• Main Authors: Frandsen, Thomas L., Abrahamsson, Jonas, Lausen, Birgitte, Vettenranta, Kim, Heyman, Mats, Behrentz, Michael, Castor, Anders, Wehner, Peder S., Frost, Britt‐marie, Andersen, Elisabeth W., Schmiegelow, Kjeld
• Format: Article
• Language: English
• Subjects: acute lymphoblastic leukaemia; Adolescent; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; chemotherapy; Child; Child, Preschool; children; Clinical Medicine; consolidation; Dose-Response Relationship, Drug; Drug Administration Schedule; Feasibility Studies; Female; Fever - chemically induced; Hematologi; Hematologic and hematopoietic diseases; Hematology; Humans; Infant; Klinisk medicin; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Mercaptopurine - administration & dosage; Mercaptopurine - adverse effects; Methotrexate - administration & dosage; Methotrexate - adverse effects; Mucositis - chemically induced; Pancreatitis - chemically induced; Pilot Projects; Precision Medicine; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; purine analogues; TECHNOLOGY; TEKNIKVETENSKAP
• ISSN: 0007-1048; 1365-2141; 1365-2141
• DOI: 10.1111/j.1365-2141.2011.08835.x

Summary 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/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). This study shows individualized toxicity‐titrated 6MP dosing during consolidation is feasible without increased risk of toxicity.