Mercaptopurine in childhood acute lymphoblastic leukaemia

A partir de données portant sur 918 patients pédiatriques atteints d'une leucémie lymphoblastique et inclus dans un essai de phase III, cette étude prospective évalue l'association entre le niveau de 6-thioguanine nucléotides (6-TGN) des leucocytes circulants et la survie sans récidive pendant un traitement d'entretien à base de mercaptopurine et méthotrexate

Résumé en anglais

Unlike other cancers, acute lymphoblastic leukaemia requires prolonged therapy, consisting of induction (about 1 month), post-induction intensification (about 6 months), and maintenance or continuation therapy (18–30 months). Two decades ago, findings from a large meta-analysis1 showed a small, but significant, advantage of a third year of maintenance therapy despite more deaths from pneumocystis, varicella, and measles, which are rarely seen today, compared with shorter treatment groups. In the Tokyo Children's Cancer Study Group L92-13 study,2 maintenance therapy was terminated at 1 year from diagnosis and resulted in an event-free survival of 57% at 12 years.