Non-compliance with oral chemotherapy in childhood leukaemia

Abstract

One contributory factor used to be insufficient doses of antimetabolites. Before 1980, four year disease free survival in Britain was less than 50%. Then a more rigid and detailed national protocol was introduced, where maintenance was more aggressively applied and attenuation of the drug dose was not left up to the individual physician. The result was an increase in toxicity accompanied by a 15–20% improvement in long term survival.2 This experience has persuaded paediatric oncologists in Britain to prescribe the maximum tolerated dose of antimetabolites and to avoid interruptions to treatment wherever possible.