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Continuation therapy to eliminate residual disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Continuation of treatment is necessary to prevent or forestall relapses in patients with ALL.

  • all cases should receive chemotherapy for 2 - 2·5 years
  • usual regimens consist of daily mercaptopurine and weekly methotrexate

When using mercaptopurine, patients should be informed that the dose should be taken in the evening (than in the morning) and to avoid taking it with milk or milk products that contain xanthine oxidase (2).

Thioguanine has been shown to be superior to mercaptopurine, but the side effects have limited its use. Thoiguanine may be used in short term courses during the intensification phase of treatment (1). Reference:

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