Single-agent therapy with oral mercaptopurine for nonlymphoid blast crisisof chronic myeloid leukemia

Currently, no effective treatment is available for the nonlymphoid blast cr isis (BC) of chronic myeloid leukemia (CML) and because of this the prognos is for such patients remains invariably poor. In an attempt to determine th e results provided by palliative treatment with oral 6-mercaptopurine (6-MP ) in the above hematological condition. 30 such patients were analyzed for hospital stay, days of intravenous (i.v.) antibiotics, transfusion requirem ents, response rate, and survival. Thirty patients with nonlymphoid BC matc hed for their initial characteristics and treated with different i.v. regim ens were used for comparison purposes. Patients managed with 6-MP spent les s days in hospital (median: 9, range: 0-46 vs median: 42, range: 5-140; P < 0.0001), needed antibiotics for less days (median: 0, range: 0-46 vs median : 20. range: 0-57; P <0.0001), and received less platelet transfusions (med ian: 0, range: 0-20 vs median: 6, range: 0-63; P=0.004) than those treated with i.v. chemotherapy. Although no complete or partial remission was achie ved by patients receiving 6-MP vs six in the i.v. chemotherapy group, no si gnificant difference was observed when the survival of both groups was comp ared (median: 4.7 months, range: 0.1-22.7 vs median: 3.8 months, range: 0.2 -12, respectively). These results indicate that 6-MP therapy constitutes a good palliative treatment for patients with nonlymphoid BC of CML. However, new treatment strategies for this hematological condition are required.