6-Mercaptopurine
Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.
| ID | DRUG-MERCAPTOPURINE |
|---|---|
| Type | Médicament |
| Alias | 6-МеркаптопуринMercaptopurinePurinetholPurixan |
| État | reviewed 2026-04-27 | pending_clinical_signoff |
| Maladies | DIS-B-ALL |
| Sources | SRC-NCCN-BCELL-2025 |
Faits sur les drogues
| Catégorie | antinéoplasique — analogique de purine (thiopurine) |
|---|---|
| Mécanisme | Purine antagonist; converted by HGPRT to thio-IMP, which inhibits de novo purine biosynthesis and incorporates into DNA/RNA as thio-dGTP, causing chain termination and triggering apoptosis. Backbone of B-ALL maintenance (POMP / vincristine + MTX + 6-MP + prednisone) for 2-3 years post-induction-consolidation. |
| Dose typique | B-ALL maintenance: 50-75 mg/m² PO daily (continuous), titrated to ANC 0.75-1.5 × 10⁹/L and platelets >75 × 10⁹/L. Dose adjusted by TPMT/NUDT15 genotype if measured (intermediate metabolizers ~50% reduction; poor metabolizers ~10% of standard dose or avoid). |
| Ukraine enregistrée | Vrai |
| NSZU remboursé | Vrai |
| Ukraine vérifiée pour la dernière fois | 2026-04-27 |
Avertissements
- Severe myelosuppression (especially in TPMT- or NUDT15-deficient patients) — genotype testing recommended before initiation
- Hépatotoxicité, y compris maladie hépato-occlusive
Notes
Cornerstone of B-ALL maintenance (POMP regimen, 2-3 years post-induction- consolidation). TPMT and NUDT15 genotyping should be performed pre-initiation when available — poor metabolizers require dramatic dose reduction or alternative therapy. Take on empty stomach (food + dairy reduce absorption ~25%). Avoid allopurinol coadministration without dose reduction. Bedtime dosing improves tolerance.
Utilisé par
Protocole thérapeutique
REG-POMP-B-ALL-MAINTENANCE- Maintenance POMP — B-ALL post-induction-consolidation (vincristine + 6-MP + MTX + prednis...