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June 10, 1974

Allopurinol and Cytotoxic Agents

Author Affiliations

Boston University Medical Center Waltham, Mass

JAMA. 1974;228(11):1371-1372. doi:10.1001/jama.1974.03230360019013

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To the Editor.—  We have no argument with the contention put forward by Dr. Lyon that the clinician, when employing cytotoxic agents, generally aims to produce some degree of leukopenia to ensure an optimal clinical effect. It is also unarguable that the degree of leukopenia (or thrombocytopenia) is sometimes inadvertently greater than that desired or considered safe by the clinician. If the treatment groups were otherwise comparable, then, by chance, the proportions of inadvertently excessive depression of the white cell count (or thrombocyte count), which was what was measured in our study, should have been similiar in those receiving and those not receiving allopurinol.However, chance as an explanation for our findings, at least with regard to patients who received cyclophosphamide, could confidently be ruled out. We also believe that mean leukocyte and platelet counts of 2,314/cu mm and 55,400/cu mm, respectively, can be accepted as indirect indices of bone