6-巯嘌呤对维持治疗期急性淋巴细胞白血病患儿的不良反应及其个体化治疗研究现状  

Current research status of 6-mercaptopurine adverse reactions and individualized treatment in children with acute lymphoblastic leukemia during maintenance therapy

作　　者：王苗 沈树红[1] Wang Miao;Shen Shuhong(Department of Hematology and Oncology,Shanghai Children′s Medical Center,Medical School of Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学附属上海儿童医学中心血液肿瘤科,200127

出　　处：《国际输血及血液学杂志》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)。

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.

关 键 词：6-巯嘌呤 前体细胞淋巴母细胞白血病淋巴瘤 遗传药理学 药物毒性 个体化医学 儿童 急性淋巴细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]