Thioguanine as single agent to achieve partial remission in adult acute non-lymphocytic leukaemia in poor risk patients

ABSTRACT

Ten adult patients with acute nonlymphoblastic leukemia of poor risk presented with either low platelet or low white blood cell count. We treated with single drug 6-thioguanine. There were 7 male and 3 females with mean age 35 years. Age ranged from 14 to 70 years. The majority of patients presented with anaemia, fever, petechial and haemorrhage, gum hypertrophy, splenomegaly. According to the French-American-British classification, 6 [60%] had differentiated myelopblastic leukemia [M2], 2 [20%] had acute promyelocytic leukemia [M3] one [10%] had acute myelomonocytic leukemia [M4] and one [10%] had acute monoblastic leukemia [M5]. They were treated with 6-thioguanine therapy. The Median leucocyte/platelet and blast were 12x10[9]/L, 24x10[9]/L and 62% respectively before the therapy. After the 6-thioguanine [2-3 courses], median leucocyte/platelet and blast were 3.7x10[9]/L. 105x10[9]/L and 14% respectively complete remission was not achieved in any of these patients, but they achieved good partial remission. Then they were subsequently received conventional D.A.T. regimen. There were minimal side effects. We found that the thioguanine is a safe, effective drug in acute non-lymphoblastic leukemia. When patient presents with low WBC/platelet count and no facility for blood component or growth factors available