Molecular diagnosis of thiopurine Smethyltransferase deficiency: genetic basis for azathioprine and mercaptopurine
As expected, a mercaptopurine
treatment of infected rats either untreated or treated with Cy significantly inhibited [alpha]2M synthesis, showing a maximal [alpha]2M level of 182 [micro]g/ ml (Cy untreated) and 231 [micro]g/ml (Cy treated), on the second and the fourth day post-infection, respectively (Fig.
Identifying patients having high risk of developing toxicity with mercaptopurine
is important as toxicity gives undue morbidity and mortality (7,8,22).
High-performance liquid chromatographic assay of the methyl and nucleotide metabolites of 6-mercaptopurine
: quantitation of red blood cell 6-thioguanine nucleotide, 6-thioinosinic acid and 6-m ethyl mercaptopurine
metabolites in a single sample.
Preponderance of thiopurine Smethyltransferase deficiency and heterozygosity among patients intolerant to mercaptopurine
Differing contribution of thiopurine methyltransferase to mercaptopurine
versus thioguanine effects in human leukemic cells.
Use with caution with azathioprine, mercaptopurine
, and warfarin: Coadministration can heighten anticoagulation level.
De novo purine synthesis inhibition and antileukemic effects of mercaptopurine
alone or in combination with methotrexate in vivo.
TPMT is an enzyme known to be involved specifically in the metabolism of mercaptopurine
, which is commonly used for childhood acute lymphoblastic leukemia, and the immunosuppressant azathioprine (Imuran).
The spectrum of thiopurine metabolites that can be measured by our assay methodology (thioguanine, 8-hydroxymercaptopurine, mercaptopurine
, 8hydroxythioguanine, thioxanthine, and thiouric acid plus methylthioguanine and the methyhnercaptopurine metabolites) are safe from oxidation and stable for several days when back-extracted or reconstituted in 0.
Vinblastine plus etoposide, prednisone, and mercaptopurine
is more effective than monotherapy.