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July 1967

Allopurinol in the Treatment of Neoplastic Disease Complicated by Hyperuricemia

Author Affiliations

New York

From the Columbia University College of Physicians and Surgeons, and the Medical Services of Presbyterian Hospital and of Francis Delafield Hospital, New York. Dr. Ball was formerly a clinical Fellow of the American Cancer Society.

Arch Intern Med. 1967;120(1):12-18. doi:10.1001/archinte.1967.00300010014003

THE INVESTIGATION of agents suppressing the oxidative degradation of mercaptopurine1 led to the recognition of the potential clinical usefulness of the xanthine oxidase inhibitors which interfere with the final conversion of the oxypurines (hypoxanthine and xanthine) to uric acid.2 One of these compounds, allopurinol (Zyloprim), has been shown to be useful in the management of gout and hyperuricemia where inadequate control had been achieved with colchicine and uricosuric drugs.3-14 Since the reduction in serum uric acid takes place by a process of enzyme inhibition, allopurinol is effective in the presence of renal disease and it does not increase the risk of uric acid crystallization within the urinary tract.

In patients with neoplastic disease, there is often a significant increase in purine catabolism and hyperuricemia.15-17 Occasionally during the course of cancer and of leukemia or lymphoma, one may, in addition, observe gouty arthritis18 or renal calculi.19