摘要
急性淋巴细胞白血病(ALL)是儿童最常见的恶性血液肿瘤。6-巯嘌呤(6-MP)是ALL患儿维持治疗期采用的核心药物,其不良反应主要为骨髓抑制及肝不良反应,严重不良反应的发生可能导致患儿治疗被中断或者继发感染等。6-MP治疗维持治疗期ALL患儿导致的不良反应具有显著个体差异,临床医师如何平衡其过程中的风险与收益,以及基于其药物基因组及代谢产物水平调整6-MP剂量,已成为相关研究热点。为了指导维持治疗期ALL患儿6-MP的临床用药方案调整,笔者拟就6-MP的不良反应与其代谢产物、药物基因多态性间的关系,以及个体化用药等方面的研究现状进行介绍。
Acute lymphoblastic leukemia(ALL)is the most common malignant hematologic neoplasms in children.6-mercaptopurine(6-MP)is the core drug for the treatucent of children with ALL during maintenance therapy,The possible adverse effects of 6-MP for children with All during maintenace therapy are mainly bone marrow suppression and liver toxicity.Occurrence of serious adverse reactions may lead to interruption of treatment or secondary infection.However,adverse effects of 6-MP have obvious individual differences.It is trending for pediatricians to make a trade-off between risk and benefits from the drug dose adjustment based on pharmacogenomics and therapeutic drug monitoring,which has been a hot spot of related research.To guide 6-MP clinical medication,this article reviews research status on relationship among adverse reactions,6-MP metabolites and pharmacogenomics,and progress of individualized therapy.
作者
王苗
沈树红
Wang Miao;Shen Shuhong(Department of Hematology and Oncology,Shanghai Children′s Medical Center,Medical School of Shanghai Jiaotong University,Shanghai 200127,China)
出处
《国际输血及血液学杂志》
CAS
2021年第2期93-100,共8页
International Journal of Blood Transfusion and Hematology
基金
转化医学国家重大科技基础设施(上海)开放项目(NRCTM(SH)-2019-04)
国家自然科学基金(81270623)。
