Maintenance Treatment With Low-Dose Mercaptopurine in Combination With Allopurinol in Children With Acute Lymphoblastic Leukemia and Mercaptopurine-Induced Pancreatitis

Pediatr Blood Cancer. 2016 Apr;63(4):712-5. doi: 10.1002/pbc.25841. Epub 2015 Nov 24.

Abstract

Mercaptopurine (6-mercaptopurine, 6MP) is a mainstay of curative therapy in childhood acute lymphoblastic leukemia (ALL), and contributes to its 90% overall survival rate. We present two patients with ALL who suffered with severe pancreatitis secondary to 6MP. Through the use of allopurinol in conjunction with reduced dose 6MP, we were able to continue 6MP without further pancreatitis. This report contributes to the small body of literature on 6MP associated pancreatitis in childhood ALL and describes a novel approach to continued use of 6MP during therapy.

Keywords: acute lymphoblastic leukemia; allopurinol; mercaptopurine; pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Allopurinol / administration & dosage*
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Child
  • Humans
  • Male
  • Mercaptopurine / administration & dosage*
  • Mercaptopurine / adverse effects
  • Pancreatitis / chemically induced
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*

Substances

  • Antimetabolites, Antineoplastic
  • Allopurinol
  • Mercaptopurine