Clinical Evaluation of 5 Days of Administration of 6-Mercaptopurine at the Dose of 175 mg/m2/day Versus 250 mg/m2/day
Oral 6-mercaptopurine (6-MP) is an integral component of maintenance chemotherapy for children with acute lymphoblastic leukemia (ALL). A clinical comparative study of 6-MP given at 175 mg/m2/day vs. 250 mg/m2/day for 5 days was carried out. Ten patients on a CCLSG ALL 874 and 911 study received 6-M...
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| Published in | The Japanese Journal of Pediatric Hematology Vol. 15; no. 5; pp. 367 - 371 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY
2001
特定非営利活動法人 日本小児血液・がん学会 |
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| Online Access | Get full text |
| ISSN | 0913-8706 1884-4723 |
| DOI | 10.11412/jjph1987.15.367 |
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| Abstract | Oral 6-mercaptopurine (6-MP) is an integral component of maintenance chemotherapy for children with acute lymphoblastic leukemia (ALL). A clinical comparative study of 6-MP given at 175 mg/m2/day vs. 250 mg/m2/day for 5 days was carried out. Ten patients on a CCLSG ALL 874 and 911 study received 6-MP at 175 mg/m2/day and 9 patients on a CCLSG ALL 941 study received 6-MP at 250 mg/m2/day. There was no significant difference in the value of WBC, Hb, and platelet counts between these two groups. The mean value of GPT level was significantly increased in a higher dosage group with no delay of 6-MP administration. The mean value of GPT peak level was decreased gradually following repeated cycles of 6-MP administration. Five days of 6-MP at 250 mg/m2/day was well tolerated and safe for the maintenance chemotherapy of childhood ALL. |
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| AbstractList | Oral 6-mercaptopurine (6-MP) is an integral component of maintenance chemotherapy for children with acute lymphoblastic leukemia (ALL). A clinical comparative study of 6-MP given at 175 mg/m2/day vs. 250 mg/m2/day for 5 days was carried out. Ten patients on a CCLSG ALL 874 and 911 study received 6-MP at 175 mg/m2/day and 9 patients on a CCLSG ALL 941 study received 6-MP at 250 mg/m2/day. There was no significant difference in the value of WBC, Hb, and platelet counts between these two groups. The mean value of GPT level was significantly increased in a higher dosage group with no delay of 6-MP administration. The mean value of GPT peak level was decreased gradually following repeated cycles of 6-MP administration. Five days of 6-MP at 250 mg/m2/day was well tolerated and safe for the maintenance chemotherapy of childhood ALL. Oral 6-mercaptopurine (6-MP) is an integral component of maintenance chemotherapy for children with acute lymphoblastic leukemia (ALL). A clinical comparative study of 6-MP given at 175 mg/m2/day vs. 250 mg/m2/day for 5 days was carried out. Ten patients on a CCLSG ALL 874 and 911 study received 6-MP at 175 mg/m2/day and 9 patients on a CCLSG ALL 941 study received 6-MP at 250 mg/m2/day. There was no significant difference in the value of WBC, Hb, and platelet counts between these two groups. The mean value of GPT level was significantly increased in a higher dosage group with no delay of 6-MP administration. The mean value of GPT peak level was decreased gradually following repeated cycles of 6-MP administration. Five days of 6-MP at 250 mg/m2/day was well tolerated and safe for the maintenance chemotherapy of childhood ALL. 小児急性リンパ性白血病の維持療法に6-mercaptopurine (6-MP) は必須の治療薬である.今回われわれは, 6-MP投与量を175mg/m2/日5日間から250mg/m2/日5日間に増量し, その臨床的検討を行った.経口6-MP 175mg/m2/日投与はCCLSG ALL874,911研究で治療した10例, 6-MP 250mg/m2/日投与はCCLSG ALL 941研究で治療した9例である.2群で投与後の白血球数, ヘモグロビン値, 血小板数に差はみられなかった.6-MP 250mg/m2/日投与例にGPT値が有意な上昇がみられたが, 予定治療の遷延傾向は認めなかった.またGPT値の上昇は6-MPの治療を繰り返すごとにピーク値の低下傾向がみられた.6-MP投与量を175 mg/m2/日5日間から250mg/m2/日5日間に増量しても副作用の増強はなく, 耐えうる投与量と考えられた. |
| Author | IWATA, Atsuko MATSUSHITA, Takeji FUJIMOTO, Takeo HORI, Toshinori HIROTA, Takahisa |
| Author_FL | 岩田 敦子 廣田 貴久 藤本 孟男 松下 竹次 堀 壽成 |
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| Publisher | THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 特定非営利活動法人 日本小児血液・がん学会 |
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| References | 4) Koizumi S, Fujimoto T, Oka T, et al : Overview of clinical studies of childhood acute lymphoblastic leukemia for more than ten years by the Japanese Children's Cancer and Leukemia Study Group. PediatrHematol Oncol 14 : 17-28, 1997 7) Balis FM, Hekenberg JS, Poplack DG, et al : Pharmacokinetic and pharmacodynamics of oral meth-otrexate and mercaptopurine in children with lower risk acute lymphoblastic leukemia : A joint Children's Cancer Group and Pediatric Oncology Branch Study. Blood 92 : 3569-3577, 1998 11) Schmiegelow K, Glomstein A, Kristinsson J, et al : Impact of morning versus evening schedule for oral methotrexate and 6-mercaptopurine on relapse risk for children with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 19 : 102-109, 1997 2) Burchenal JH, Murphy ML, Ellison, RR, et al : Clinical evaluation of a new antimetabolite, 6-mercaptopurine, in the treatment of leukemia and allied diseases. Blood 8 : 965-987, 1953 13) 松下竹次, 鬼塚礼子, 関口典子, 他 : *急性リンパ性白血病における6-MPの薬理動態 (第2報).臨床血液40 : 1009, 1999 10) Dibenedetto SP, Guardabasso V, Regusa R, et al : 6-mercaptopurine cumulative dose : A critical factor of maintenance therapy in average risk childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 11 : 251-258, 1994 3) Balis FM, Holcenberg JS, Poplack DG : General principles of chemotherapy. Principles and Practice of Pediatric Oncology, Pizzo PA et al ed 3rd ed Lippincott-Raven Philadelphia/New York 1997,215-272 6) Relling MV, Hancock ML, Boyett JM, et al : Prognostic importance of 6-mercaptopurine dose intensity in acute lymphoblastic leukemia. Blood 93 : 2817-2823, 1999 5) 小泉晶一 : High Risk群一急性白血病の治療.癌と化学療法26 : 1042-1049, 1999 9) Koizumi S, Fujimoto T, Takeda T, et al : Comparison of intermittent or continuous methotrexate plus 6-mercaptopurine in regimens for standard-risk acute lymphoblastic leukemia in childhood (JCCLSGS811). Cancer 61 : 1292-1300, 1988 1) 藤本孟男 : 小児癌・白血病研究グループの急性リンパ性白血病の治療理念と成績.小児内科29 : 219-228, 1997 8) Hale JP, Lilleyman JS : Importance of 6-mercaptopurine dose in lymphoblastic leukaemia. Arch Dis Child 66 : 462-466, 1991 12) Berkovitch M, Matsui D, Zipursky A, et al : Hepatotoxicity of 6-mercaptopurine in childhood acute lymphocytic leukemia : Pharmacokinetic characteristics. Med Pediatr Oncol 26 : 85-89, 1996 |
| References_xml | – reference: 7) Balis FM, Hekenberg JS, Poplack DG, et al : Pharmacokinetic and pharmacodynamics of oral meth-otrexate and mercaptopurine in children with lower risk acute lymphoblastic leukemia : A joint Children's Cancer Group and Pediatric Oncology Branch Study. Blood 92 : 3569-3577, 1998 – reference: 2) Burchenal JH, Murphy ML, Ellison, RR, et al : Clinical evaluation of a new antimetabolite, 6-mercaptopurine, in the treatment of leukemia and allied diseases. Blood 8 : 965-987, 1953 – reference: 11) Schmiegelow K, Glomstein A, Kristinsson J, et al : Impact of morning versus evening schedule for oral methotrexate and 6-mercaptopurine on relapse risk for children with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 19 : 102-109, 1997 – reference: 4) Koizumi S, Fujimoto T, Oka T, et al : Overview of clinical studies of childhood acute lymphoblastic leukemia for more than ten years by the Japanese Children's Cancer and Leukemia Study Group. PediatrHematol Oncol 14 : 17-28, 1997 – reference: 9) Koizumi S, Fujimoto T, Takeda T, et al : Comparison of intermittent or continuous methotrexate plus 6-mercaptopurine in regimens for standard-risk acute lymphoblastic leukemia in childhood (JCCLSGS811). Cancer 61 : 1292-1300, 1988 – reference: 1) 藤本孟男 : 小児癌・白血病研究グループの急性リンパ性白血病の治療理念と成績.小児内科29 : 219-228, 1997 – reference: 5) 小泉晶一 : High Risk群一急性白血病の治療.癌と化学療法26 : 1042-1049, 1999 – reference: 12) Berkovitch M, Matsui D, Zipursky A, et al : Hepatotoxicity of 6-mercaptopurine in childhood acute lymphocytic leukemia : Pharmacokinetic characteristics. Med Pediatr Oncol 26 : 85-89, 1996 – reference: 13) 松下竹次, 鬼塚礼子, 関口典子, 他 : *急性リンパ性白血病における6-MPの薬理動態 (第2報).臨床血液40 : 1009, 1999 – reference: 6) Relling MV, Hancock ML, Boyett JM, et al : Prognostic importance of 6-mercaptopurine dose intensity in acute lymphoblastic leukemia. Blood 93 : 2817-2823, 1999 – reference: 8) Hale JP, Lilleyman JS : Importance of 6-mercaptopurine dose in lymphoblastic leukaemia. Arch Dis Child 66 : 462-466, 1991 – reference: 3) Balis FM, Holcenberg JS, Poplack DG : General principles of chemotherapy. Principles and Practice of Pediatric Oncology, Pizzo PA et al ed 3rd ed Lippincott-Raven Philadelphia/New York 1997,215-272 – reference: 10) Dibenedetto SP, Guardabasso V, Regusa R, et al : 6-mercaptopurine cumulative dose : A critical factor of maintenance therapy in average risk childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 11 : 251-258, 1994 |
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| Title | Clinical Evaluation of 5 Days of Administration of 6-Mercaptopurine at the Dose of 175 mg/m2/day Versus 250 mg/m2/day |
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