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Mercaptopurine (6MP) and methotrexate are the cornerstones of maintenance therapy in pediatric patients with acute lymphoblastic leukemia. However, although bone marrow suppression and liver dysfunction are common side effects of these antimetabolites, 6MP-induced hypoglycemia during the maintenance phase is rare. Guidelines and international protocols are well established for the management of bone marrow suppression and liver dysfunction, but promptly identifying 6MP-induced hypoglycemia is the key to its control. Here we report 2 cases of leukemia that developed hypoglycemia during the maintenance phase. Both patients were boys younger than 6 years of age and both suffered symptomatic morning hypoglycemia induced by 6MP (which was diagnosed after excluding all other possible causes). Successful management included changing the time of 6MP administration from evening to morning. Other management options are also discussed.

Application of 3-Naphthyl-1-(4-trifluoromethyl)-5-(4-carboxy phenyl)-2-pyrazoline (NFCP) as a novel fluorigenic label for the derivatization of biogenic amines (BAs) and separation by liquid chromatography (LC) was investigated. Optimum conditions for the pre-column derivatization and chromatographic separation were investigated. The resulting derivatives are fluorescent at λex/λem: 380/460 nm. For the sake of evaluating the efficacy of the proposed analysis of BAs of different nature, the formation of nine NFCP-BAs derivatives was tested individually. Simultaneous derivatization and separation of four BAs (histamine, tyramine, tryptamine, and phenylethylamine) were achieved under the isocratic elution mode. Furthermore, the derivatives were identified by the characteristic product ion obtained during LC-MS/MS analysis. The viability of the method was established by measuring levels of histamine in fresh and spoiled fish samples. Histamine concentrations were found to be 0.4 µgg-1 and 4.1 µgg-1 in fresh and spoiled tuna fish samples respectively. As a simple, reliable, and sensitive pre-column derivatization method, this work provides for future research to develop a novel HPLC method for the analysis of BAs from food samples such as fish and various other matrices by utilizing the new pyrazoline compound.