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Acute lymphoblastic leukemia (ALL) studies across the globe have shown that delivering optimal maintenance therapy (MT) is crucial to achieve better treatment outcomes [1]. Delivering optimal MT includes prescribing maximum tolerated doses of 6-mercaptopurine (6MP) and methotraxate (MTX) based on patient’s blood counts (absolute neutrophil count (ANC), platelet count (PLT) and hemoglobin (HB)). In view of this, the allMT package was created to analyse and visualize the MT data (ANC/PLT/HB/6MP/MTX) for single patient or a given cohort at any center1. The package was developed considering the ICiCLe-ALL-14 protocol [3] as default. It can be used to analyze data from centers with different MT protocols where in the user will need to alter the function defined ipnut argument/parameters.


Using this package the user may:

  1. Convert maintenance sheets (Tata Medical Center Kolkata, India format or user dependent) into a cleaner, single csv with longitudinal data for each patient.

  2. Analyze MT [2]


You can install the development version of allMT from GitHub with:

# install.packages("devtools")

Ethics approval statement for data

The anonymized clinical data set refers to patients treated on the ICiCLe-ALL-14 treatment protocol at the Tata Medical Center Kolkata (institutional review board approval EC/TMC/12/13 for the treatment protocol). Funding support for the ICiCLe-ALL-14 clinical study (Clinical Trials Registry-India reference CTRI/2015/12/006434) was provided by the National Cancer Grid (2016/001; 2016-) and the Indian Council of Medical Research (79/159/2015/NCD-III; 2017-19)


By abiding to Contributor Code of Conduct, contribution to allMT in any form bug fixes/code modification/new code development is welcomed.


K. Schmiegelow, S. N. Nielsen, T. L. Frandsen, and J. Nersting, “Mercaptopurine/methotrexate maintenance therapy of childhood acute lymphoblastic leukemia: Clinical facts and fiction,” Journal of pediatric hematology/oncology, vol. 36, no. 7, p. 503, 2014.
T. D. Mungle, “Modelling clinical decision processes to optimise maintenance chemotherapy in children with acute lymphoblastic leukaemia,” PhD thesis, IIT Kharagpur, 2020.
N. Das et al., “Protocol for ICiCLe-ALL-14 (InPOG-ALL-15-01): A prospective, risk stratified, randomised, multicentre, open label, controlled therapeutic trial for newly diagnosed childhood acute lymphoblastic leukaemia in india,” Trials, vol. 23, no. 1, pp. 1–20, 2022.

  1. The work was initiated as part of Tushar Mungle’s PhD work at IIT Kharagpur [2] and then continued at TTCRC, Tata Medical Center, Kolkata.↩︎