Sensitivity to Purine Analogues in Childhood Leukemia Assessed by the Automated MTT-Assay
In the last two decades the survival rate of children with acute lymphoblastic leukemia (ALL) has improved greatly. However, with a complete remission percentage close to 100%, about 35% of the children still get a relapse. In a previous study it was shown that in childhood common-ALL, 5′nucleotidase (5′NT) positive cases have a poorer prognosis than 5′NT negative cases (Veerman et al., 1985). This might be due to the breakdown of the cytotoxic nucleotides of 6-MP by high cytoplasmic 5′NT activities. Alternatively, ecto 5′NT can provide purine requirements of the purine salvage pathway and therefore rescue cells from a blockage of purine de novo synthesis by 6-MP and/or MTX (Thompson, 1985; Pieters et al., 1987a). Thirdly, 5′NT positive cases might be relatively resistant to cytostatic drugs in general.
KeywordsLeukemia Sarcoma Methotrexate Glucocorticoid Pyrimidine
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