6-mercaptopurine plasma levels in children with acute lymphoblastic leukemia: relation to relapse risk and myelotoxicity.

Abstract:

:Plasma levels of 6-mercaptopurine were determined in 22 consecutive children with acute lymphoblastic leukemia on oral remission maintenance therapy during the time period of August 1984 to January 1988. Each child received the drug once daily for up to 3 years and was studied repeatedly (1-12 times). An HPLC method was used for drug analysis. We found large interpatient variations in the mean peak plasma concentration (range of 50-424 ng/ml) and in the mean area under the concentration vs. time from 0-4 h curve (range of 82-637 ng ml-1 h). There were also pronounced variations between different sampling occasions in the same patient. Nine of the 22 patients had complications during the maintenance therapy. Five children with a mean peak plasma level below 135 ng/ml and a mean area under the curve (AUC) value below 251 ng ml-1 h relapsed (three in the central nervous system and two in the bone marrow). Both children with a bone marrow relapse died. Relapse risk was related to the AUC (p less than 0.05). Four children with a mean peak plasma level above 166 ng/ml and a mean AUC value above 363 ng/ml/h developed severe myelotoxicity, which necessitated a temporary cessation of the maintenance therapy. In addition, two patient relapsed 6 and 11 months after termination of maintenance therapy. Their mean peak and AUC values were not low but the concentrations decreased markedly towards the end of the maintenance period. The results indicate that the plasma levels of 6-mercaptopurine, when determined repeatedly, might be of significance for the outcome of the remission maintenance treatment.

journal_name

Ther Drug Monit

authors

Hayder S,Lafolie P,Björk O,Peterson C

doi

10.1097/00007691-198911000-00001

subject

Has Abstract

pub_date

1989-11-01 00:00:00

pages

617-22

issue

6

eissn

0163-4356

issn

1536-3694

journal_volume

11

pub_type

杂志文章
  • Plasma concentrations of dothiepin and its metabolites are not correlated with clinical efficacy in major depressive illness.

    abstract::Plasma concentration-antidepressant response relationships for dothiepin, nordothiepin, dothiepin-S-oxide, and nordothiepin-S-oxide were investigated in 50 patients (33 women and 17 men), who had had a major depressive episode. Depression and anxiety were assessed at the start of therapy and after 2 and 4 weeks by mea...

    journal_title:Therapeutic drug monitoring

    pub_type: 临床试验,杂志文章

    doi:10.1097/00007691-199310000-00001

    authors: Ilett KF,Blythe TH,Hackett LP,Ong RT,Tannenbaum DA,Clarke TM

    更新日期:1993-10-01 00:00:00

  • Interlaboratory variability in drug assay: a comparison of quality control data with reanalysis of routine patient samples. I: Anticonvulsant drugs and theophylline. Clinical Pharmacology and Toxicology Study Group, Italian Society for Clinical Biochemist

    abstract::The interlaboratory variability in the assay of theophylline and various anticonvulsant drugs was evaluated in a 16-month prospective study by using two independent experimental approaches: (a) a conventional method based on the distribution of quality control (QC) lyophilized human sera spiked with the test drugs (ph...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:

    authors:

    更新日期:1991-03-01 00:00:00

  • Evaluation of therapeutic drug monitoring of methotrexate in saliva of children with rheumatic diseases.

    abstract::Pediatric patients with leukemia, other malignancies, and rheumatological disease receive methotrexate chronically. Because of the documented correlation between methotrexate levels of compliance and clinical outcome, it is conceivable to verify appropriate systemic exposure to the drug. Saliva sampling may be of pote...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199506000-00006

    authors: Press J,Berkovitch M,Laxer R,Giesbrecht E,Verjee Z,Silverman E,Klein J,Koren G

    更新日期:1995-06-01 00:00:00

  • Spironolactone as a source of interference in commercial digoxin immunoassays.

    abstract::Eight commercial digoxin immunoassay methods were tested in 17 subjects taking spironolactone (but not digoxin) to evaluate cross-reactivity from parent drug and/or metabolites. Four of these methods showed significant (up to 1.9 nmol/L) and variable "apparent digoxin" concentrations, despite the absence of digoxin in...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-198706000-00014

    authors: Morris RG,Lagnado PY,Lehmann DR,Frewin DB,Glistak ML,Burnet RB

    更新日期:1987-06-01 00:00:00

  • Comparison of three immunoassays for the determination of N-acetylprocainamide. Determination of false elevations by a polyclonal antibody-based method.

    abstract::The performance of the ROCHE FP NAPA reagent, a newly reformulated monoclonal antibody-based fluorescence polarization immunoassay (FPIA) for N-acetylprocainamide, was compared with two commercially available polyclonal antibody-based immunoassays, the Abbott TDx and Syva EMIT. Although excellent correlation was obser...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199406000-00013

    authors: Laurino JP,McKay J,Fischberg E,Schwenzer K,Kaufman R

    更新日期:1994-06-01 00:00:00

  • Ability of a first-pass pharmacokinetic model to characterize cyclosporine blood concentrations after administrations of Sandimmune or Neoral formulations.

    abstract::Most recent cyclosporine (CsA) pharmacokinetic (PK) studies have focused on noncompartmental analysis. Because CsA undergoes significant first-pass elimination after oral dosing, the most appropriate compartment model may need to take this process into account for the construction of a valid population PK model for Sa...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199804000-00006

    authors: Ducharme MP,Verret L,Brouillette D,Sirois G

    更新日期:1998-04-01 00:00:00

  • A comparative bioavailability study of carbamazepine tablets and a chewable tablet formulation.

    abstract::Differences in product formulations have been shown to affect the therapeutic response by altering the relative bioavailability and pharmacokinetics of a drug. The relative bioavailability and pharmacokinetics of carbamazepine tablets (CBZ) and a chewable tablet formulation were evaluated in 10 normal healthy subjects...

    journal_title:Therapeutic drug monitoring

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007691-198703000-00006

    authors: Maas B,Garnett WR,Pellock JM,Comstock TJ

    更新日期:1987-01-01 00:00:00

  • Routine methods in toxicology and therapeutic drug monitoring by high performance liquid chromatography. II. A rapid microscale method for determination of chloramphenicol in blood and cerebrospinal fluid.

    abstract::A highly sensitive, specific method for determining chloramphenicol levels in human blood plasma and cerebrospinal fluid is described. The method uses high performance liquid chromatography for the analysis, requires minimal quantities of patient specimen, and thus is suitable for use in newborn and pediatric patients...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-198709000-00016

    authors: Sood SP,Green VI,Bailey CL

    更新日期:1987-09-01 00:00:00

  • Pharmacokinetic and other drug interactions in patients with AIDS.

    abstract::A variety of medications are used in treating patients infected with the human immunodeficiency virus (HIV). These medications are used to control viremia and to prevent and treat opportunistic infections. An individual is often required to take numerous drugs at the same time and thus clinicians are confronted with p...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章,评审

    doi:10.1097/00007691-200112000-00001

    authors: Dasgupta A,Okhuysen PC

    更新日期:2001-12-01 00:00:00

  • Extended-Interval Dosing of Gentamicin Aiming for a Drug-Free Period in Neonates: A Prospective Cohort Study.

    abstract:BACKGROUND:Current gentamicin dosing algorithms in adult populations target a high peak concentration (Cmax) assuring efficacy and a drug-free period (concentration <0.5 mg/L) preventing toxicity. In contrast, gentamicin-based regimens in neonatal sepsis often aim for lower peak levels and trough concentrations of 0.5-...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0000000000000283

    authors: van Maarseveen EM,Sprij A,Touw DJ

    更新日期:2016-06-01 00:00:00

  • Quantitative determination of tolbutamide and its metabolites in human plasma and urine by high-performance liquid chromatography and UV detection.

    abstract::An isocratic, high-performance liquid chromatography method has been developed for simultaneous determination of the oral antidiabetic tolbutamide and two of its metabolites, 4-hydroxytolbutamide and carboxytolbutamide, in human plasma and urine. The method was based on simple one-step liquid-liquid extraction with te...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199912000-00015

    authors: Hansen LL,Brøsen K

    更新日期:1999-12-01 00:00:00

  • Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

    abstract:BACKGROUND:Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regul...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0b013e31828526b4

    authors: Fulga N

    更新日期:2013-06-01 00:00:00

  • Serum Concentrations of Paliperidone After Administration of the Long-Acting Injectable Formulation.

    abstract:BACKGROUND:The pharmacokinetics of long-acting intramuscular paliperidone in a naturalistic setting is not well documented. The objective of this study was to investigate the relationship between dose and serum concentrations of paliperidone using data from a routine therapeutic drug monitoring service. METHODS:Serum ...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0000000000000457

    authors: Helland A,Spigset O

    更新日期:2017-12-01 00:00:00

  • In Vivo Cytochrome P450 3A Isoenzyme Activity and Pharmacokinetics of Imatinib in Relation to Therapeutic Outcome in Patients With Chronic Myeloid Leukemia.

    abstract:BACKGROUND:Cytochrome P450 3A (CYP3A) isoenzyme metabolic activity varies between individuals and is therefore a possible candidate of influence on the therapeutic outcome of the tyrosine kinase inhibitor imatinib in patients with chronic myeloid leukemia (CML). The aim of this study was to investigate the influence of...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0000000000000268

    authors: Skoglund K,Richter J,Olsson-Strömberg U,Bergquist J,Aluthgedara W,Ubhayasekera SJ,Vikingsson S,Svedberg A,Söderlund S,Sandstedt A,Johnsson A,Aagesen J,Alsenhed J,Hägg S,Peterson C,Lotfi K,Gréen H

    更新日期:2016-04-01 00:00:00

  • Thiopurine therapies: problems, complexities, and progress with monitoring thioguanine nucleotides.

    abstract::Metabolism of thiopurine drugs--azathioprine, 6-mercaptopurine, and 6-thioguanine--has provided a powerful pharmacogenetic model incorporating polymorphism of the enzyme thiopurine methyltransferase (TPMT) and the primary active metabolite, thioguanine nucleotide (TGN). However, a sense of uncertainty about the useful...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章,评审

    doi:10.1097/01.ftd.0000169061.52715.3e

    authors: Duley JA,Florin TH

    更新日期:2005-10-01 00:00:00

  • South Africa: a toxicologist's goldmine.

    abstract::The emerging nation of South Africa, in common with some other countries, notably Eastern Europe, is heir to decades of neglect with regards to the exposure of the majority of its population to toxic materials. In this short review, the major toxic health hazards are described. For most of these risks there are now pr...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章,评审

    doi:10.1097/00007691-200202000-00027

    authors: Stewart MJ

    更新日期:2002-02-01 00:00:00

  • Analysis of midazolam and metabolites in plasma by high-performance liquid chromatography: probe of CYP3A.

    abstract::Hydroxylation of midazolam (MDZ) is mediated almost exclusively by CYP3A isoforms. The authors describe a high-performance liquid chromatography assay involving MDZ, 1'-hydroxymidazolam, and 4-hydroxymidazolam in plasma. The compounds were eluted on an Ultrasphere ODS, 3-microm particle size, 7.5 cm x 4.6 mm reversed-...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199806000-00013

    authors: Carrillo JA,Ramos SI,Agundez JA,Martinez C,Benitez J

    更新日期:1998-06-01 00:00:00

  • Plasma assay of salbutamol by means of high-performance liquid chromatography with amperometric determination using a loop column for injection of plasma extracts. Application to the evaluation of subcutaneous administration of salbutamol.

    abstract::An isocratic high-performance liquid chromatography method with amperometric detection for the assay of plasma salbutamol is described. The plasma extract is injected into the chromatographic system via a loop column. This insures the purification of the injected extracts and allows a simple and rapid liquid-solid ext...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199206000-00011

    authors: Tamisier-Karolak L,Delhotal-Landes B,Jolliet-Riant P,Milliez J,Jannet D,Barre J,Flouvat B

    更新日期:1992-06-01 00:00:00

  • Effect of plasma exchange on flumequine pharmacokinetics: comparison with control kinetics.

    abstract::The effect of plasma exchange (PE) on the pharmacokinetics of flumequine (Apurone) was studied in eight patients receiving a single oral dose of 800 mg. The maximum concentration (38 micrograms/ml) and time to maximum concentration (2.6 h) values were not significantly altered by PE beginning 3 h after administration ...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199107000-00003

    authors: Royer-Morrot MJ,Gérard A,Zhiri A,Schooneman F,Dureux JB,Royer RJ

    更新日期:1991-07-01 00:00:00

  • Pharmacokinetics of 5-fluorouracil after short systemic infusion: plasma level at the end of the distribution phase as an indicator of the total area under the plasma concentration-time curve.

    abstract::The correlation between single plasma concentration (CP) values of 5-fluorouracil (FU) after a 10-minute i.v. infusion and the total area under the plasma concentration-time curve (AUC) has been studied in 26 cancer patients. FU dose was either 320-550 mg/m2 (seven patients, 13 treatments) or 610-960 mg/m2 (19 patient...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:

    authors: Port RE,Edler L,Herrmann R,Feldmann U

    更新日期:1991-03-01 00:00:00

  • Coloring, bleaching, and perming: influence on EtG content in hair.

    abstract:BACKGROUND:Hair analysis of ethyl glucuronide (EtG) has become, beside fatty acid ethyl ester, a valuable marker for the detection of moderate and chronic excessive alcohol consumption. So far, only few studies exist about the influence of cosmetic treatment on EtG content in hair. The aim of this study was to evaluate...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0b013e31828ca246

    authors: Kerekes I,Yegles M

    更新日期:2013-08-01 00:00:00

  • Pharmacokinetic modeling and development of Bayesian estimators in kidney transplant patients receiving the tacrolimus once-daily formulation.

    abstract:BACKGROUND:The once-daily formulation of tacrolimus has been reported to exhibit the same efficacy and safety profile as compared with the immediate-release form administered twice daily. However, as a result of differences in their pharmacokinetic (PK) profile, the PK models or Bayesian estimators (MAP-BE) previously ...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0b013e3181cc70db

    authors: Saint-Marcoux F,Debord J,Undre N,Rousseau A,Marquet P

    更新日期:2010-04-01 00:00:00

  • Solid-phase extraction and high-performance liquid chromatography for therapeutic monitoring of haloperidol levels.

    abstract::This laboratory has developed a simple and efficient solid-phase extraction method that is combined with a high-performance liquid chromatographic method for rapid and precise therapeutic monitoring of haloperidol (Haldol) blood levels. The solid-phase extraction utilizes a mixed bed column. Sensitivity of the chromat...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199410000-00011

    authors: Hoffman DW,Edkins RD

    更新日期:1994-10-01 00:00:00

  • Population Pharmacokinetics of Hydroxychloroquine in Japanese Patients With Cutaneous or Systemic Lupus Erythematosus.

    abstract:BACKGROUND:Hydroxychloroquine (HCQ) is an effective treatment for patients with cutaneous lupus erythematosus (CLE) or systemic lupus erythematosus (SLE) and has been used for these patients in more than 70 nations. However, in Japan, HCQ has not been approved for CLE or SLE. To establish an appropriate therapeutic reg...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0000000000000261

    authors: Morita S,Takahashi T,Yoshida Y,Yokota N

    更新日期:2016-04-01 00:00:00

  • Pharmacokinetics of high-dose oral and intravenous dexamethasone.

    abstract::Pharmacokinetics of intravenous and oral pulsed high-dose dexamethasone were studied in four patients with pemphigus vulgaris. Doses for dexamethasone were varied from 100 to 300 mg. Serum concentrations were measured by high-performance liquid chromatographic procedure with diode assay detection. Bioavailability was ...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199910000-00007

    authors: Tóth GG,Kloosterman C,Uges DR,Jonkman MF

    更新日期:1999-10-01 00:00:00

  • Efficiency and Safety of an Early Dose Adjustment of Ribavirin in Patients Infected With Hepatitis C Underexposed to the Drug and Treated With Peginterferon Ribavirin.

    abstract:BACKGROUND:Ribavirin exposure after the first dose (D0AUC0-4h) >1755 mcg·h·L is predictive of sustained virological response (SVR) in patients with hepatitis C treated with peginterferon and ribavirin. The aim of this study was to test the benefit of ribavirin early dose adjustment based on this target in naïve patient...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/FTD.0000000000000332

    authors: Loustaud-Ratti V,Maynard M,Thevenon S,Pradat P,Rousseau A,Alain S,Deny P,Gagnieu MC,Tran A,Dao T,Silvain C,Lunel-Fabiani F,Picard N,Zublena I,Marquet P,Trepo C,RIBAJUSTE Group.

    更新日期:2016-12-01 00:00:00

  • Determination of vigabatrin in plasma by reversed-phase high-performance liquid chromatography.

    abstract::A method is described for the determination of vigabatrin in 50 microliters of plasma by isocratic high-performance liquid chromatography using fluorescence detection. The procedure involves protein precipitation with methanol followed by precolumn derivatisation with o-phthaldialdehyde reagent. Separation of the deri...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-199105000-00011

    authors: Tsanaclis LM,Wicks J,Williams J,Richens A

    更新日期:1991-05-01 00:00:00

  • Comparison of aminoglycoside clearance and calculated serum creatinine clearances.

    abstract::Calculated creatinine clearance (CrCL) estimates are frequently used as estimates of aminoglycoside clearance (AGCL), despite being inadequately studied. Thirty surgical intensive care unit (SICU) patients with stable serum creatinines (0.6-6.3 mg/dl) and steady-state aminoglycoside levels were studied. A one-compartm...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/00007691-198903000-00006

    authors: Deeter RG,Krauss EA,Penn F,Nahaczewski AE

    更新日期:1989-01-01 00:00:00

  • Randomized, trough blood cyclosporine concentration-controlled trial to compare the pharmacodynamics of Sandimmune and Neoral in de novo lung transplant recipients.

    abstract::The greater and more consistent absorption of cyclosporine from the microemulsion formulation (Neoral; Novartis Pharmaceuticals Ltd., Frimley, UK) when compared with that from the original form (Sandimmune; Novartis Pharmaceuticals Ltd., Frimley, UK) results in greater systemic exposure. Lung transplant recipients cou...

    journal_title:Therapeutic drug monitoring

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007691-199902000-00004

    authors: Trull A,Steel L,Sharples L,Stewart S,Parameshwar J,McNeil K,Wallwork J

    更新日期:1999-02-01 00:00:00

  • Evaluation of Infliximab and Anti-infliximab LISA-TRACKER Immunoassays for the Therapeutic Drug Monitoring of SB2 Infliximab Biosimilar.

    abstract:BACKGROUND:SB2, an infliximab (IFX) biosimilar to the reference infliximab (R.I.) product (Remicade), received approval in the European Union for all IFX indications. Many decision algorithms based on the measurement of IFX trough levels and antibodies to infliximab are being increasingly used to optimize IFX treatment...

    journal_title:Therapeutic drug monitoring

    pub_type: 杂志文章

    doi:10.1097/FTD.0000000000000565

    authors: Jentzer A,Berger AE,Labetoulle R,Haccourt A,Roblin X,Paul S

    更新日期:2018-12-01 00:00:00