EFFECT OF CHEMOTHERAPY ON THE ENERGY AND PROTEIN-METABOLISM OF CHILDREN NEAR THE END OF TREATMENT FOR ACUTE LYMPHOBLASTIC-LEUKEMIA

Eight children in the final 3 mo of chemotherapy for acute lymphoblast ic leukemia were studied while on oral 6-mercaptopurine (6MP) maintena nce therapy and then again 4-9 mo after chemotherapy had been complete d. Six of the eight were also studied a second time while on 6MP in th e 24-h period after receiving intravenous methotrexate (MTX). 6MP redu ced protein oxidation after a test meal and reduced fasting urinary ur ea excretion by enhancing the reutilization of endogenous amino acids for protein synthesis. MTX had no detectable effects on protein metabo lism but reduced overnight carbohydrate utilization by enhancing fat u tilization. A similar enhancement of fat utilization was evident after a test meal. The two drugs in combination resulted in effects on prot ein and energy metabolism that were the sum of the individual effects plus an increase in the rate of whole-body protein turnover and synthe sis.