In Vivo Chemoselection with Low Dose Thioguanine
The present disclosure is directed to methods of selecting for modified stem cells in vivo. The present disclosure is also directed to a 6TG dosing schedule. The present disclosure is also directed to an oral formulation comprising 6TG.
1 . A method of increasing stem cell engraftment comprising administering to a human patient one or more doses of 6TG, wherein an amount of 6TG in each dose ranges from between about 0.2 mg/kg/day to about 0.6 mg/kg/day following a stem cell transplant, wherein a total amount of 6TG administered in any cycle does not exceed 7 mg/kg.
2 . The method of claim 1 , wherein the amount of 6 TG in each dose ranges from between about 0.3 mg/kg/day to about 0.5 mg/kg/day.
3 . The method of claim 2 , wherein the amount of 6TG in each dose is about 0.4 mg/kg/day.
4 . The method of claim 1 , wherein the one or more doses of 6TG are administered on schedule having a cycle selected from the group consisting of (i) weekly; (ii) every other week; (iii) one week of therapy followed by two, three or four weeks off; (iv) two weeks of therapy followed by one, two, three or four weeks off; (v) three weeks of therapy followed by one, two, three, four or five weeks off; (vi) four weeks of therapy followed by one, two, three, four or five weeks off; (vii) five weeks of therapy followed by one, two, three, four or five weeks off; and (viii) monthly.
5 . The method of claim 1 , wherein between about 3 and about 10 doses of 6TG are administered to the human patient over an administration period ranging from 1 week to about 4 weeks.
6 . The method of claim 5 , wherein 4 or 5 doses of 6TG are administered to the patient over a 14-day administration period.
7 . The method of claim 6 , wherein the doses of 6TG are spaced apart over equal time periods.
8 . The method of claim 6 , wherein the doses of 6TG are made every third day.
9 . The method of claim 6 , wherein each dose comprises the same amount of 6TG.
10 . The method of claim 6 , wherein at least one subsequent dose of 6TG comprises an amount of 6TG greater than an amount of 6TG in an initial dose.
11 . The method of claim 1 , wherein a time period between dosing the human patient with 6TG and the stem cell transplant ranges from between about 2 weeks to about 6 weeks.
12 . The method of claim 1 , wherein the amount of the 6TG administered is based on a measured HPRT-enzyme activity level.
13 . The method of claim 1 , wherein the total amount of 6TG administered in the cycle does not exceed 5 mg/kg.
14 . A method of conferring myeloprotection comprising: (i) performing a myelosuppressive conditioning step prior to a stem cell transplantation, the myelosuppressive conditioning step comprising administering one or more doses of 6TG to induce selective myelotoxicity; and (ii) performing a post-transplantation chemoselection step following stem cell transplantation, wherein the post-transplantation conditioning step comprises administering one or more doses of 6TG, where each of the one or more doses comprises an amount of 6TG ranging from about 0.3 mg/kg to about 0.5 mg/kg.
15 . The method of claim 14 , wherein the amount of 6TG is about 0.4 mg/kg.
16 . The method of claim 14 , wherein the post-transplantation conditioning step occurs over an administration period ranging from 1 week to about 4 weeks, and wherein between about 3 and about 10 doses of 6TG are administered over the administration period, and wherein a total dose of 6TG during the administration period does not exceed 5 mg/kg.
17 . The method of claim 16 , wherein 4 or 5 doses of 6TG are administered over a 14-day period.
18 . The method of claim 16 , wherein each dose comprises the same amount of 6TG.
19 . The method of claim 16 , wherein at least one subsequent dose comprises an amount of 6TG greater than an amount of 6TG in an initial dose.
20 . A formulation for oral administration comprising 6TG, wherein the 6TG is present in an amount ranging from between about 0.2 mg to about 0.6 mg, and at least one pharmaceutically acceptable excipient.