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To the Editor.—
The article, "Allopurinol and Cytotoxic Drugs" (227-1036, 1974), has raised the suggestion that the combined use of allopurinol and cytotoxic chemotherapy may not be justified. This conclusion is based on a claim of an increased incidence of "bone marrow depression" in patients with neoplastic diseases who received allopurinol combined with cytotoxic drugs.One wonders whether adequate criteria have been used in this study to define "bone marrow depression." Cytotoxic agents, on their own, cause leukopenia and thrombocytopenia, and therefore, limits for acceptable and unacceptable depressions of leukocyte and thrombocyte counts should have been established. In any event, on the basis of the data presented, it is hard to see how the authors could have generalized to such an extent in their final conclusion. In the text, they themselves state that the frequency of leukocyte and thrombocyte depression in those patients receiving other cytotoxic drugs (other than cyclophosphamide)
Randall RF. Allopurinol. JAMA. 1974;229(6):638–639. doi:10.1001/jama.1974.03230440014010
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