ABSTRACT
The purine analog 6-mercaptopurine was synthesized by Hitchings and Elion in the late 1940s. The first clinical trial was conducted with an oral regimen, and this trial showed a beneficial effect in the treatment of acute leukemia in children. The doses used were obtained from trials in laboratory animals. Until the early 1960s the prognosis in childhood acute lymphoblastic leukemia was very poor. Most patients died without achieving a remission. With the introduction of better immunological subgrouping, multidrug combinations, and better supportive care, 90% of patients today achieve a complete remission. This oral and long-term treatment with a cytostatic drug has been criticized, comparing the treatment with antimicrobiological chemotherapeutic treatment and claiming that the treatment should be administered intravenously to achieve maximum tolerated dose.
