Case 18: Acute Lymphoblastic leukemia A 5-year-old girl was admitted to the hospital suffering from loss of appetite, we

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Case 18: Acute Lymphoblastic leukemia
A 5-year-old girl was admitted to the hospital suffering from
loss of appetite, weakness, pain in the joints, and fewer.
The child’s spleen, liver, and lymph nodes were to be enlarged. A
diagnosis of acute lymphoblastic leukemia was made. The patient was
immediately given prednisone, vincristine, and L-asparaginase.
Allopurinol was begun as a prophylactic measure. On induction
of remission, central nervous system
prophylaxis involved the injection of methotrexate and radiation
treatment. Maintenance therapy involved the administration of
6-mercaptopurine and methotrexate, with occasional pulses of
vincristine and prednisone for a period of 21/2 to 3 years.
Biochemical questions:
1. What is the mechanism of action of the drugs used in
this case?
2. The compounds listed have some serious side effects
when high dosages are administered. Why?
3. What are the side effects of cancer therapy in a
5-year-old child?
4. Why was allopurinol administered?
5. Why must the 6-mercaptopurine level be reduced if
allopurinol is used in the treatment?