Personalized Treatment of 6-Mercaptopurine in Thai Children with Acute Lymphoblastic Leukemia

Thanks to its ability to inhibit deoxyribonucleic acid synthesis, 6-mercaptopurine (6-MP), is one of the indispensable medications for acute lymphoblastic leukemia (ALL) patients. Nevertheless, some patients may succumb to myelotoxicity, leading to treatment disruption or even life-threatening events. Owing to the advances in pharmacogenomics, the genetic polymorphism of genes regulating purine synthesis has been identified and physicians can adjust the dose of 6-MP according to each polymorphism. Such polymorphisms genetically vary among ethnicities. In this article, 2 genetic polymorphisms, namely thiopurine methyltransferase and Nudix (nucleoside diphosphate linked moiety X) type motif 15, are clinically discussed, with a special focus on the clinical studies in Thai children with ALL.