Allopurinol use during maintenance therapy for acute lymphoblastic leukemia avoids mercaptopurine-related hepatotoxicity

Nicole M. Giamanco, Bethany S. Cunningham, Laura S. Klein, Dina S. Parekh, Anne B. Warwick, Kenneth Lieuw

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

6-Mercaptopurine (6-MP) is the mainstay of treatment for acute lymphoblastic leukemia and lymphoblastic lymphoma. It is metabolized into the pharmacologically active, 6-thioguanine nucleotide (6-TGN), and 6-methyl mercaptopurine nucleotides (6-MMPN), which is associated with hepatotoxicity that jeopardizes antileukemic therapy. Allopurinol alters the metabolism of 6-MP to increase 6-TGN levels and decreases 6-methyl mercaptopurine nucleotides levels. We report 2 cases in which combination therapy of allopurinol with 6-MP was used successfully to avoid hepatotoxicity while delivering adequate 6-TGN levels. We suggest that this combination therapy can be used safely to change the metabolite production in patients who develop excessive hepatotoxicity.

Original languageEnglish (US)
Pages (from-to)147-151
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume38
Issue number2
DOIs
StatePublished - Jan 1 2016

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All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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