mercaptopurine and Hodgkin-Disease

Although cytotoxic immunosuppressive agents play an unquestionably useful role in treating many neoplastic and non-neoplastic disorders, there is accumulating evidence that the toxicity associated with their use is considerable. The therapeutic successes obtained with antitumor agents have led to increases in the life span of cancer patients, but have also provided the opportunity for this toxicity to become manifest. A search of the available literature was carried out, with emphasis on cases in which a malignancy developed in patients following chemotherapy for either neoplastic or non-neoplastic (e.g., renal transplantation, psoriasis) conditions; particular focus was given to the incidence of acute myelogenous leukemia in various groups of Hodgkin's disease and multiple myeloma patients. That patients with nonmalignant conditions treated with cytotoxic immunosuppressive agents are also at increased risk of developing a malignancy raises the possibility that these agents may have oncogenic potential. Therefore, one may be faced with the paradox that the patients benefiting most from chemotherapy may be at highest risk of suffering its consequences.

Topics: Alkylating Agents; Animals; Antineoplastic Agents; Azathioprine; Burkitt Lymphoma; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Hodgkin Disease; Humans; Immunosuppressive Agents; Kidney Neoplasms; Leukemia, Myeloid, Acute; Lymphoma; Mechlorethamine; Melphalan; Mercaptopurine; Methotrexate; Mice; Multiple Myeloma; Neoplasms; Prednisone; Pregnancy; Procarbazine; Time Factors; Vincristine

Topics: Adrenal Cortex Hormones; Alkylating Agents; Antibiotics, Antineoplastic; Antineoplastic Agents; Cytarabine; Drug Synergism; Drug Therapy, Combination; Fluorouracil; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mitosis; Neoplasm Metastasis; Thymine Nucleotides

Topics: Adult; Burkitt Lymphoma; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Combinations; Hodgkin Disease; Humans; Immunotherapy; Infections; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Mercaptopurine; Methotrexate; Middle Aged; Nitrogen Mustard Compounds; Prednisone; Procarbazine; Prognosis; Remission, Spontaneous; Vincristine

Topics: Alkylating Agents; Antibiotics, Antineoplastic; Antimetabolites; Antineoplastic Agents; Carmustine; Chlorambucil; Cyclophosphamide; Dactinomycin; Evaluation Studies as Topic; Fluorouracil; Hodgkin Disease; Humans; Mechlorethamine; Mercaptopurine; Methotrexate; Prednisone; Procarbazine; Thiotepa; Vinblastine; Vincristine

Topics: Adult; Antineoplastic Agents; Asparaginase; Carmustine; Child; Cyclophosphamide; Cytarabine; Cytosine; Daunorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Immunotherapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lymphoma; Male; Mechlorethamine; Mercaptopurine; Methotrexate; Nitrogen Mustard Compounds; Prednisolone; Prednisone; Procarbazine; Remission, Spontaneous; Vincristine

Topics: Agammaglobulinemia; Antibody Formation; Biomedical Research; Child; Genetics, Medical; Hodgkin Disease; Humans; Immune Tolerance; Infant, Newborn; Lymph Nodes; Lymphoid Tissue; Mercaptopurine; Neoplasms; Neoplasms, Experimental; Radiation Effects; Research; Skin Transplantation; Thymectomy; Thymus Gland; Transplantation; Transplantation Immunology

Plasma concentrations of 6-mercaptopurine (6-MP) were determined by gas chromatography-mass spectrometry. Ten children (nine with acute lymphatic leukemia) were studied on 2 consecutive days after oral intake of 6-MP. On one day the drug was administered in the fasting state and on the other (in random order) together with breakfast. The peak plasma concentrations of 6-MP after the dose intake with breakfast in percent of that in the fasting state (meal in % of fasting for each individual) varied between 33 and 181% (mean 111), and the area under the plasma concentration-time curve varied between 47 and 186% (mean 103). Thus, there were considerable variations among patients, but, for the group as a whole, there were no statistically significant differences between the two experimental conditions. This study cannot therefore form the basis for a recommendation as to whether 6-MP should be administered on an empty stomach or together with food.

Topics: Administration, Oral; Adolescent; Biological Availability; Child; Child, Preschool; Drug Administration Schedule; Fasting; Female; Food; Hodgkin Disease; Humans; Intestinal Absorption; Male; Mercaptopurine; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Crohn's disease (CD) patients may be at increased risk for the development of Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL), either through exposure to immunosuppressive medications or due to their underlying chronic inflammatory illness. There are limited data regarding the natural history of CD following treatment of lymphoma. We present a series of CD patients who were treated for lymphoma and describe the natural history of their CD following lymphoma treatment.. Retrospective case series from three academic referral centers was used. All CD patients with a history of lymphoma were identified. Demographic data, CD medication exposure, and surgical procedures before and after lymphoma treatment were recorded.. Nine CD patients with a history of lymphoma were identified. Eight individuals received chemotherapy, while one patient was observed without treatment. Eight patients remained free of lymphoma for a mean of 72.8 months (range 1-276 months). The ninth patient had recurrence of his HL 3 years after lymphoma diagnosis. Following lymphoma treatment, two patients had quiescent CD with no specific therapy. Three patients demonstrated significant clinical relapse of their CD and a fourth patient developed CD after treatment of her lymphoma, which ultimately required long-term immunomodulator therapy with 6-mercaptopurine or methotrexate in the first three patients, and azathioprine in the fourth. Four patients required CD surgery after lymphoma treatment.. We report on the clinical course of CD in patients who develop lymphoma. Significant clinical relapse of CD following successful medical treatment of lymphoma occurred frequently in patients with a history of this neoplasm.

Topics: Adolescent; Adult; Antineoplastic Agents; Child; Crohn Disease; Female; Hodgkin Disease; Humans; Immunosuppressive Agents; Lymphoma; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Methotrexate; Middle Aged; Retrospective Studies; Treatment Outcome; Young Adult

Topics: Animals; Child; Dogs; Drug Evaluation; Hodgkin Disease; Humans; Kinetics; Leukemia, Lymphoid; Mercaptopurine

19 months after the clinical manifestation of acute lymphoblastic leukaemia, Hodgkin's disease, stage Ia, of the cervical lymphnodes developed in a 10 year old girl during continuous complete remission of leukaemia under chemotherapy. After a regional irradiation and after completing the antileukamic therapy the patient is at present off therapy, healthy and without signs of relapse of both malignant systemic diseases. The coincidence of acute lymphoblastic leukaemia in children with other malignant neoplasias is rare. The expected frequency of second malignancies and the theories concerning oncogenesis are shortly reviewed.

Topics: Child; Female; Hodgkin Disease; Humans; Leukemia, Lymphoid; Lymph Nodes; Mercaptopurine; Methotrexate; Methylprednisolone; Neck; Neoplasms, Multiple Primary; Remission, Spontaneous; Vincristine

Topics: Asparaginase; Child; Cyclophosphamide; Cytosine; Daunorubicin; Doxorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lymphoma; Melphalan; Mercaptopurine; Methotrexate; Neoplasms; Nitrogen Mustard Compounds; Osteosarcoma; Prednisone; Procarbazine; Prognosis; Remission, Spontaneous; Rhabdomyosarcoma; Teniposide; Thioguanine; Vincristine; Wilms Tumor

Topics: Acute Disease; Adolescent; Daunorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Leukemia, Lymphoid; Male; Mechlorethamine; Mercaptopurine; Prednisone; Procarbazine; Remission, Spontaneous; Sulfates; Vincristine

Thirteen patients with Wegener's granulomatosis have been treated with cytotoxic agents. Only one died from the disease whereas two died of infectious complications of therapy and one of heart disease. Seven of the nine survivors are well without medication; one is alive with renal insufficiency and one is in the 5th year of treatment. Cholorambucil was least toxic and should be tried first. Cyclophosphamide was more effective than cholorambucil or azathioprine but, because of side effects, should rarely be used initially. Differentiation of Wegener's granulomatosis from lymphomatiod granumatosis, which it resembles clinically, roentgenologically and pathologically, is important since the latter disease responds differently to cytoxic drug therapy.

Topics: Azathioprine; Cyclophosphamide; Drug Evaluation; Granuloma; Granulomatosis with Polyangiitis; Hodgkin Disease; Humans; Lung Diseases; Mercaptopurine; Prednisone; Prognosis; Remission, Spontaneous

Topics: Abdominal Neoplasms; Adult; Aged; Antineoplastic Agents; Breast Neoplasms; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Female; Fluorouracil; Gallbladder Neoplasms; Hodgkin Disease; Humans; Kidney Neoplasms; Liver Neoplasms; Lymphoma, Large B-Cell, Diffuse; Male; Mercaptopurine; Middle Aged; Pancreatic Neoplasms; Prednisolone; Rectal Neoplasms; Stomach Neoplasms; Ultrasonography; Vincristine

Topics: Adult; Aged; Anemia, Hemolytic, Autoimmune; Autopsy; Azathioprine; Brain; Breast Neoplasms; Female; Hodgkin Disease; Humans; Immunosuppression Therapy; Infection Control; Infections; Kidney Transplantation; Lung; Lupus Erythematosus, Systemic; Male; Mercaptopurine; Middle Aged; Myocardium; Neoplasm Metastasis; Prednisone; Toxoplasmosis; Transplantation, Homologous

Topics: Antineoplastic Agents; Asparaginase; Cell Division; Chemistry; Culture Techniques; Cytarabine; Daunorubicin; Depression, Chemical; DNA; Drug Combinations; Drug Resistance; Germ-Free Life; Half-Life; History, 20th Century; Hodgkin Disease; Humans; Leukemia; Lymphatic Diseases; Mercaptopurine; Remission, Spontaneous; Stimulation, Chemical; Thioguanine

Topics: Adult; Age Factors; Benzoates; Blood Cell Count; Blood Platelets; Cyclophosphamide; Drug Combinations; Female; Hodgkin Disease; Humans; Lymphoma; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Middle Aged; Prednisone; Procarbazine; Time Factors; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Aminoisobutyric Acids; Asparagine; Child; Female; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Thymine; Vinblastine

Topics: Anemia, Hemolytic, Autoimmune; Anti-Bacterial Agents; Antimetabolites; Blood Specimen Collection; Bone Marrow Diseases; Busulfan; Chromosome Aberrations; Diuretics; Hodgkin Disease; Humans; Karyotyping; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemoid Reaction; Mercaptopurine; Prednisone; Specimen Handling; Thrombocytopenia; Time Factors

Topics: Aminopterin; Attitude of Health Personnel; Blood Transfusion; Bone Marrow Transplantation; Death; Hodgkin Disease; Humans; Leukemia, Lymphoid; Mercaptopurine; Physician-Patient Relations; Prednisone; Terminal Care; Vincristine

Topics: Antineoplastic Agents; Bone Marrow; Bone Marrow Cells; Bone Marrow Diseases; Bone Marrow Examination; Busulfan; Chlorambucil; Cortisone; Daunorubicin; Etiocholanolone; Female; Hematologic Diseases; Hodgkin Disease; Humans; Leukemia; Leukocyte Count; Male; Mercaptopurine; Radiation Effects; Vinblastine

Topics: Adenocarcinoma; Antineoplastic Agents; Chlorambucil; Colchicine; Culture Techniques; Cyclophosphamide; Dactinomycin; Female; Floxuridine; Fluorouracil; Hodgkin Disease; Humans; Melphalan; Mercaptopurine; Methotrexate; Nandrolone; Neoplasms; Nitrogen Mustard Compounds; Norethindrone; Prednisolone; Progesterone; Testosterone; Thiotepa; Uterine Neoplasms; Vinblastine

Topics: Antineoplastic Agents; Busulfan; Carcinoma, Squamous Cell; Child; Chlorambucil; Choriocarcinoma; Dactinomycin; Female; Fluorouracil; Gonadal Steroid Hormones; Hodgkin Disease; Humans; Hydrazines; Leukemia; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Mesenchymoma; Methotrexate; Multiple Myeloma; Nitrogen Mustard Compounds; Ovarian Neoplasms; Pregnancy; Prostatic Neoplasms; Steroids; Testicular Neoplasms; Urethane; Vinblastine; Vincristine; Wilms Tumor

Topics: Adrenal Cortex Hormones; Adult; Antimetabolites; Antineoplastic Agents; Blood Transfusion; Child; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Plasmacytoma; Prednisone; Vincristine

Topics: Cyclophosphamide; Hodgkin Disease; Humans; Mercaptopurine; Methotrexate; Prednisone; Vincristine

Topics: Adrenal Cortex Hormones; Alkylating Agents; Child; Cyclophosphamide; Drug Therapy; Herpes Zoster; Hodgkin Disease; Leukemia; Lymphoma; Mechlorethamine; Mercaptopurine; Methotrexate; Neoplasms; Prednisolone; Surgical Procedures, Operative; Thrombocytopenia

Topics: Antineoplastic Agents; Child; Chlorambucil; Cyclophosphamide; Drug Therapy; Ganglioneuroma; Gastrointestinal Diseases; Hodgkin Disease; Leukemia; Leukemia, Myeloid; Liver Neoplasms; Lymphoma; Mechlorethamine; Mercaptopurine; Methotrexate; Neoplasms; Pathology; Radiation Injuries; Stomach; Toxicology; Vinblastine; Vincristine; Wilms Tumor

Topics: Alkylating Agents; Aminopterin; Busulfan; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mechlorethamine; Mercaptopurine; Methotrexate; Multiple Myeloma; Neoplasms; Pathology; Primary Myelofibrosis; Sarcoma; Triethylenemelamine; Tuberculosis; Tuberculosis, Pulmonary; Urethane

Topics: Adrenal Cortex Hormones; Chlorambucil; Cyclophosphamide; Dermatitis, Exfoliative; Genetic Diseases, X-Linked; Geriatrics; Hodgkin Disease; Leukemia; Leukemia, Hairy Cell; Leukemia, Lymphoid; Lymphatic Diseases; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mercaptopurine; Methotrexate; Mycosis Fungoides; Neoplasms; Pathology; Peptide Nucleic Acids; Physiology; Sarcoma; Severe Combined Immunodeficiency

Topics: Chlorambucil; Hematopoiesis; Hodgkin Disease; Humans; Lymphoma; Lymphoma, Non-Hodgkin; Mercaptopurine; Neoplasms; Paraplegia; Prednisone; Spinal Cord Compression

Topics: Adrenal Cortex Hormones; Antimetabolites; Antineoplastic Agents; Child; Hodgkin Disease; Humans; Infant; Leukemia; Lymphatic Metastasis; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Neoplasms; Neuroblastoma; Nitrogen Mustard Compounds; Toxicology; Vincristine

Topics: Aziridines; Blood Platelets; Bone Marrow; Busulfan; Cell Division; Colchicine; Erythropoiesis; Hematopoiesis; Hodgkin Disease; Leukemia; Leukemia, Myeloid; Mercaptopurine; Pharmacology; Rats; Research; Reticulocytes; Vinblastine

Topics: Adrenal Cortex Hormones; Busulfan; Chlorambucil; Cortisone; Cyclophosphamide; Hodgkin Disease; Humans; Leukemia; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mechlorethamine; Mercaptopurine; Methotrexate; Neoplasms; Palliative Care; Sarcoma; Vinblastine

Topics: Busulfan; Hodgkin Disease; Inflammation; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukocyte Count; Lymphoma; Lymphoma, Non-Hodgkin; Mercaptopurine; Nitrogen Mustard Compounds; Skin Tests; Skin Window Technique

Topics: Antineoplastic Agents; Busulfan; Colchicine; Early Diagnosis; Hodgkin Disease; Mechlorethamine; Mercaptopurine; Neoplasms; Phenylalanine; Podophyllum; Triethylenemelamine; Vinblastine

Topics: Adrenal Cortex Hormones; Aged; Bone Marrow; Busulfan; Chlorambucil; Cyclophosphamide; Hodgkin Disease; Humans; Leukemia; Lymphoid Tissue; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mercaptopurine; Methotrexate; Multiple Myeloma; Neoplasms; Sarcoma

Topics: Blood; Cytodiagnosis; Hodgkin Disease; Humans; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mercaptopurine; Neoplasms; Sarcoma; Vinblastine

Topics: Child; Hematopoiesis; Hodgkin Disease; Humans; Mercaptopurine; Purines