Clinical efficacy and safety of 6-thioguanine in the treatment of childhood acute lymphoblastic leukemia

Abstract

Background: To systematic review the efficacy and safety of 6-thioguanine (6-TG) in the substitute of 6-mercaptopurine (6-MP) in the treatment for patients with childhood acute lymphoblastic leukemia (ALL) in the maintenance phase, and to explore its clinical application value. It provides theoretical guidance for the maintenance treatment of ALL in children from the perspective of evidence-based medicine. Methods: By means of computer retrieval, Chinese databases were searched: Chinese Biomedical Database (CBM), China national knowledge internet (CNKI), Chongqing Weipu Database (VIP), and Wanfang Database; Foreign databases: PubMed, The Cochrane Library, Embase, and Web of Science were applied to find out randomized controlled trial (RCT) for 6-TG in childhood acute lymphoblastic leukemia. By manual retrieval, documents without electronic edition and related conference papers were retrieved. The retrieval time ranges from the beginning of the establishment of the databases to September 1st, 2019. According to the inclusion, and exclusion criteria by 3 researchers, the literature screening, data extraction, and research methodological quality evaluation were completed. RevMan 5.3 software was applied to evaluate the quality of the included literature, and Stata 12.0 software was used to conduct meta-analysis of the outcome indicators of the included literature. Results: This study systematically evaluated the efficacy and safety of 6-TG in the substitute of 6-MP as a maintenance drug for childhood acute lymphoblastic leukemia. Through the key outcome indicators, this study is expected to draw a scientific, practical conclusion for 6-TG in the treatment of childhood acute lymphoblastic leukemia. This conclusion will provide evidence-based medical direction for clinical treatment. Conclusion: The efficacy and safety of 6-TG in the substitute of 6-MP in the maintenance treatment of childhood acute lymphoblastic leukemia will be confirmed through this study. The conclusions will be published in relevant academic journals. Registration: PROSPERO (registration number is CRD42020150466).

A Retrospective Cohort Study of the Efficacy, Safety, and Clinical Value of 6-TG versus 6-MP Maintenance Therapy in Children with Acute Lymphoblastic Leukemia

“…Recent studies have indicated that leukopenia, neutropenia, thrombocytopenia, and elevated transaminase are all remarkably correlated with the dose of mercaptopurine drugs. The same idea can be found in the study put forward by Chen et al [46]. They have applied new methods in the study, and the conclusions drawn can also give some support to this study.…”

Genetic and pharmacological modulation of DNA mismatch repair heterogeneous tumors promotes immune surveillance

“…31 TMZ is approved for the treatment of multiple malignancies including glioblastoma, while 6TG is currently used in hematologic malignancies. 32 , 33 To assess the impact of TMZ and 6TG on our mouse cellular models, we performed a loss-of-function genetic screen using a custom pooled CRISPR library targeting 488 genes involved in DNA damage response (DDR) and repair pathways ( Table S1 ). This approach allowed the identification of genes that, when disabled, lead to drug resistance in the mouse CRC CT26 cell model.…”

Clinical Observation of Zhengyuan Capsule Combined with Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer

“…Distinct from other breast cancer, the incidence of triple-negative breast cancer in young women is also higher, coupled with the larger size of the tumor. Relatively, TNBC develops rapidly and its outcome and morbidity within 5 years are poor and very high, respectively [ 5 ].…”