| Title | Random serum methotrexate determinations for assessing compliance with maintenance therapy for childhood acute lymphoblastic leukemia. | | Author(s) | Carlos Jaime-Pérez J, Gómez-Almaguer D, Sandoval-González A, Chapa-Rodríguez A, Gonzàlez-Llano O | | Institution | Department of Hematology, "Dr. José Eleuterio González" University Hospital, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México. | | Source | Leuk Lymphoma 2009 Oct 8. | | Abstract | The cure rate for acute lymphoblastic leukemia (ALL) may exceed 85%. Up to three years of maintenance therapy with weekly methotrexate (MTX) and daily 6-mercaptopurine is required. Compliance with maintenance is essential to eliminate the residual leukemic clone. We determined the compliance status of children with ALL treated at a University Hospital. The study had three phases: a direct structured interview, the search for lack of compliance documented in the clinical files, and measurement of serum MTX levels, in three random occasions, using a polarized fluorescent immunoassay. In 5 of 49 (10%) interviews, at least an episode of non-compliance was reported. In the clinical file, 8 of 49 (16.3%) patients referred skipping maintenance drugs. In 14 of 49 (28.6%) children, MTX was not present in serum in at least one measurement. Face-to-face interviews and clinical file notes were unreliable sources for monitoring compliance. Random determination of serum MTX levels should be given consideration for monitoring long-term compliance with maintenance therapy in children with ALL. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19860612 |
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