Acute lymphoblastic leukemia: are Egyptian children adherent to maintenance therapy?
نویسندگان
چکیده
UNLABELLED BACKGROUND, AIMS, SETTINGS AND DESIGN: Poor adherence to oral maintenance chemotherapy can cause relapse of acute lymphoblastic leukemia (ALL). A multicenter study for the evaluation of adherence to oral 6-mercaptopurine (6-MP) maintenance chemotherapy for childhood ALL in Egypt to identify contributing factors and possible steps to promote adherence. MATERIALS AND METHODS The study included 129 children with ALL in complete remission receiving 6-MP single daily oral dose in the evening. Evaluation was done through specific questionnaires for the patients as well as serum 6-MP measurements. RESULTS Nonadherence was detected in around 56% by questionnaires and around 50% by serum 6-MP level measurement. There was a highly significant correlation between nonadherence as found by the questionnaire and 6-MP level (P - 0.001). Nonadherence was significantly associated with low socioeconomic standard, noneducation and low educational level and large family size by both methods. High cost to come for follow-up visits was significant by questionnaire but not by 6-MP measurement. Adolescent age, the higher number of siblings, lack of written instructions, long time spent per visit, were all associated with higher rates of nonadherence, although none reached statistical significance. CONCLUSIONS Nonadherence is a real problem in pediatric patients. Specific questionnaires can be an excellent reliable method for the routine follow-up of these children, and drug level assay can be requested only for confirmation. This protocol is especially effective in developing countries where financial resources may be limited. Every effort should be made to uncover its true incidence, contributing factors, and best methods of intervention.
منابع مشابه
Metronomic Effect as A New Hypothesis in Maintenance Therapy of Acute Lymphoblastic Leukemia
متن کامل
T Regulatory Cells Frequency During Maintenance Phase Chemotherapy for Pediatric Acute Lymphoblastic Leukemia
Background: Drugs used in cancer treatment specifically kill T regulatory cells. Objective: To determine different phenotypes of T regulatory cells during the maintenance phase chemotherapy for pediatric acute lymphoblastic leukemia (ALL). Materials: We evaluated the percentages of regulatory T cells by flow cytometry. Soluble CTLA-4 (sCTLA-4) ...
متن کاملBrain MRI Findings in Children with Acute Lymphoblastic Leukemia
Background: Patients with leukemia are facing more complications in order to achieve longer survival. We aimed to evaluate the frequency of central nervous system abnormalities (CNS) on MRI of children with acute lymphoblastic leukemia (ALL). Methods: Sixty-six children with diagnosis of ALL aged 2-18 years were recruited. Non-contrast sequences of brain MRI in addition to diffusion weighted i...
متن کاملAssessment of Thiopurine–based drugs according to Thiopurine S-methyltransferase genotype in patients with Acute Lymphoblastic Leukemia
For the past half century, thiopurines have earned themselves a reputation as effective anti-cancer and immunosuppressive drugs. Thiopurine S-methyltransferase (TPMT) is involved in the metabolism of all thiopurines and is one of the main enzymes that inactivates mercaptopurine. 6-MP is now used as a combination therapies for maintenance therapy of children with acute lymphocytic leukemia (A...
متن کاملPneumothorax and Acute Kidney Injury in the Early Phase of Acute Lymphoblastic Leukemia Induction Therapy due to Aspergillus Fumigatus and Pneumocystis Jirovecii Co-Infection: A Case Report
Leukemia is the most common malignancy in children which leads to immunosuppression and predisposes patients to opportunistic infections. We report a 12-year-old girl with acute lymphoblastic leukemia (ALL) who developed simultaneous infection with pneumocystis Jirovecii pneumonia and aspergillosis in the induction phase of chemotherapy. The patient developed pulmonary cavitation and pneumothor...
متن کاملOverview the Causes of Early Deaths and Advance Supportive Care in Children with Acute Lymphoblastic Leukemia: A Systematic Review
Introduction: The objective of this study is to determine the major causes of early death in acute lymphoblastic leukemia (ALL). Methods: The following databases including PubMed, EMBASE, Science Direct and Google Scholar were searched for following terms: “acute lymphoblastic leukemia”, “early mortality”, “early death “ and “death in induction phase “. Inclusion criteria were all studies abo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of cancer research and therapeutics
دوره 11 1 شماره
صفحات -
تاریخ انتشار 2015