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小儿急性淋巴细胞性白血病(ALL)的缓解率可达到95％以上,但约有30％在维持治疗中复发。作为复发的原因之一,除耐药问题外,近年来还认为与维持治疗时所使用的药物或其活性代谢物作用点的浓度不足有关。 6-巯基嘌呤(6-MP)和氨甲喋呤(MTX)是维持治疗最常用药物,药量根据体表面积而定。但是据观察,用同一标准决定的用量,血浆中浓度或红细胞内浓度个体差异较大,有时尽管按规定量使用,但血中仍不能保持一定的浓度。如果说药物作用点的浓度个体差异大,则其浓度将与预后关系密切。Koren等研究了6-MP的浓度一时间曲线下面积(AUC)值与预后的关系,发现AUC与预后呈明显正相关。复发病例其数值较持续缓解病例
Pediatric acute lymphoblastic leukemia (ALL) response rate can reach 95% or more, but about 30% of the recurrence in the maintenance treatment. As one of the causes of recurrence, in addition to the drug resistance problem, in recent years, it is also considered that the concentration of the drug or active metabolite used at the time of maintenance treatment is insufficient. 6-Mercaptopurine (6-MP) and methotrexate (MTX) are the most commonly used drugs for maintenance therapy, depending on body surface area. However, it is observed that with the same standard dosage, plasma concentration or intra-erythrocyte concentration of individuals vary widely, sometimes despite the prescribed amount of use, but the blood still can not maintain a certain concentration. If the drug point of concentration of individual differences, then the concentration will be closely related to the prognosis. Koren et al. Studied the relationship between the area under the concentration curve (AUC) and the prognosis of 6-MP and found that AUC was positively correlated with the prognosis. Recurrent cases of its value than sustained relief cases