Thioguanine versus mercaptopurine for therapy of childhood lymphoblastic leukaemia: A comparison of haematological toxicity and drug metabolite concentrations

British Journal of Haematology

Volumn 102, Issue 2, 1998, Pages 439-443

  Lancaster, D L ^a   Lennard, L ^b   Rowland, K ^b   Vora, A J ^c   Lilleyman, J S ^a  

^a ST BARTHOLOMEW S HOSPITAL   (United Kingdom)

^b UNIVERSITY OF SHEFFIELD   (United Kingdom)

^c SHEFFIELD CHILDREN S HOSPITAL   (United Kingdom)

Author keywords

Childhood lymphoblastic leukaemia; Mercaptopurine; Thioguanine; Thioguanine nucleotides; Thrombocytopenia

Indexed keywords

ANTINEOPLASTIC AGENT; ASPARAGINASE; CYCLOPHOSPHAMIDE; CYTARABINE; DEXAMETHASONE; MERCAPTOPURINE; METHOTREXATE; STEROID; TIOGUANINE; VINCRISTINE;

ACUTE LEUKEMIA; ACUTE LYMPHOBLASTIC LEUKEMIA; ADOLESCENT; ANEMIA; ARTICLE; BONE MARROW TOXICITY; CANCER CHEMOTHERAPY; CHILD; CHILDHOOD CANCER; CHILDHOOD LEUKEMIA; CLINICAL ARTICLE; CLINICAL TRIAL; HUMAN; INTRAVENOUS DRUG ADMINISTRATION; NEUTROPENIA; ORAL DRUG ADMINISTRATION; PRIORITY JOURNAL; THROMBOCYTOPENIA; TREATMENT OUTCOME;

EID: 0031847470     PISSN: 00071048     EISSN: None     Source Type: Journal    
DOI: 10.1046/j.1365-2141.1998.00812.x     Document Type: Article

References (19)

1. Adamson, P.C., Poplack, D.G. & Balis, F.M. (1994) The cytotoxicity of thioguanine vs mercaptopurine in acute lymphoblastic leukemia. Leukemia Resarch, 18, 805-810.
2. Chessells, J.M., Harrison, G., Lilleyman, J.S., Bailey, C.C. & Richards, S.M. (1997) Continuing (maintenance) therapy in lymphoblastic leukaemia: lessons from MRC UKALL X. British Journal of Haematology, 98, 945-951.
3. Dolan, G., Lilleyman, J.S. & Richards, S.M. (1989) Prognostic importance of myelosuppression during maintenance treatment of lymphoblastic leukaemia. Archives of Diseases of Childhood, 64, 1231-1234.
4. Evans, W.E., Horner, M., Chu, Y.Q., Kalwinsky, D. & Roberts, V.M. (1991) Altered mercaptopurine metabolism, toxic effects, and dosage requirement in a thiopurine methyltransferase deficient child with acute lymphoblastic leukemia. Journal of Pediatrics, 119, 985-989.
5. Evans, W.H. & Relling, M.V. (1994) Mercaptopurine vs thioguanine for the treatment of acute lymphoblastic leukemia. Leukemia Research, 18, 811-814.
6. Harms, D., Janka-Schaub, G.E., Erb, N., Schöck, V., Graubner, U., Knust, F.J., Völpel, S., Müller, W., Siegert, E., Weigel, S. & Gutjahr, P. (1996) Randomized comparison of 6-mercaptopurine (6-MP) vs 6-thioguanine (6-TG) in maintenance treatment of childhood acute lymphoblastic leukaemia (ALL): preliminary clinical results. (Abstract). British Journal of Haematology, 93, (Suppl. 2), 58.
7. Lennard, L., Davies, H.A. & Lilleyman, J.S. (1993a) Is 6-thioguanine more appropriate than 6-mercaptopurine for children with acute lymphoblastic leukaemia? British Journal of Cancer, 68, 186-190.
8. Lennard, L., Gibson, B.E.S., Nicole, T. & Lilleyman, J.S. (1993b) Congenital thiopurine methyltransferase deficiency and 6-mercaptopurine toxicity during treatment for acute lymphoblastic leukaemia. Archives of Diseases of Childhood, 69, 577-579.
9. Lennard, L., Lewis, I., Michelagnoli, M. & Lilleyman, J.S. (1997a) Thiopurine methyltransferase deficiency in childhood lymphoblastic leukaemia: 6-mercaptopurine dosage strategies. Medical and Pediatric Oncology, 29, 252-255.
10. Lennard, L., Lilleyman, J.S., Van Loon, J. & Weinshilboum, R.M. (1990) Genetic variation in response to 6-mercaptopurine for childhood lymphoblastic leukaemia. Lancet, 336, 225-229.
11. Lennard, L., Rees, C.A., Lilleyman, J.S. & Maddocks, J.L. (1983) Childhood leukaemia: a relationship between intracellular 6-mercaptopurine metabolites and neutropenia. British Journal of Clinical Pharmacology, 16, 359-363.
12. Lennard, L. & Singleton, H. (1992) High performance liquid Chromatographic assay of the methyl and nucleotide metabolites of 6-mercaptopurine: quantitation of red blood cell 6-thioguanine nucleotide, 6-thioinosinic acid and 6-methylmercaptopurine metabolites in a single sample. Journal of Chromatography, 583, 83-90.
13. Lennard, L., Welch, J.C. & Lilleyman, J.S. (1997b) Thiopurine drugs in the treatment of childhood leukaemia: the influence of inherited thiopurine methyltransferase activity on drug metabolism and cytotoxicity. British Journal of Clinical Pharmacology, 44, 455-461.
14. Lilleyman, J.S. & Lennard, L. (1994) Mercaptopurine metabolism and risk of relapse in childhood lymphoblastic leukaemia. Lancet, 343, 1188-1190.
15. McLeod, H.L., Relling, M.V., Liu, Q., Pui, C.-H. & Evans, W.E. (1995) Polymorphic thiopurine methyltransferase in erythrocytes is indicative of activity in leukemic blasts from children with ALL. Blood, 7, 1897-1902.
16. Schmiegelow, K. & Bruunshuus, I. (1990) 6-thioguanine nucleotide accumulation in red blood cells during maintenance chemotherapy for childhood acute lymphoblastic leukaemia, and its relationship to leukopenia. Cancer Chemotherapy and Pharmacology, 26, 288-292.
17. Weinshilboum, R.M. (1992) Methylation pharmacogenetics: thiopurine methyltransferase as a model system. Xenobiotica, 22, 1055-1071.
18. Weinshilboum, R.M. & Sladek, S.L. (1980) Mercaptopurine pharmacogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity. American Journal of Human Genetics, 32, 651-662.
19. Welch, J.C., Lennard, L., Morton, G.C.A. & Lilleyman, J.S. (1997) Pharmacokinetics of mercaptopurine: plasma drug and red cell metabolite concentrations after an oral dose. Therapeutic Drug Monitoring, 19, 382-385.