抄録
Background
Mercaptopurine (6-MP) is a main drug during maintenance phase therapy in ALL children· Due to wide inter-individual differences in 6-MP metabolism among patients receiving identical doses of this drug¸ monitoring erythrocytes concentrations of 6-MP metabolites (6-TGN and 6-meMP) has been proposed as a useful clinical tool for evaluating treatment efficacy and toxicity·
Methods
A preliminary cross sectional study was done to assess the erythrocyte 6-TGN and 6-meMP concentrations by using Liquid Chromatography-tandem Mass Spectrometry (LCMS-MS) in thirty ALL Children who received 50mg/m2/day 6-MP for at least 1 month during maintenance phase at Cipto Mangunkusumo Hospital¸ Indonesia·
Results
The mean 6-TGN concentrations was 13.60±54.09 pmol/8×108 RBC (min-max: 0.00-292.55 pmol/8×108 RBC)¸ From thirty patients¸ twenty six patients with 6-TGN concentrations were lower than lower limit of quantification (LLOQ) (9.90 ng/mL)¸ and only 1 patient with 6-TGN concentrations corresponds to the therapeutic range (235-450 pmol/8×108 RBC)· From thirty patients¸ six patients with 6-meMP concentrations were lower than LLOQ (10.00 ng/mL)· The mean 6-meMP concentrations was 181.15±213.77 pmol/8×108 RBC (min-max: 0.00-1026.85 pmol/8×108 RBC)·
Conclusions
Most of patients had erythrocyte 6-TGN concentrations lower than the therapeutic range· All patients had erythrocyte 6-meMP concentrations below the concentrations that increased risk of hepatotoxicity· Monitoring 6-MP metabolites are needed to evaluating treatment efficacy and toxicity·
