Altered mercaptopurine metabolism, toxic effects, and dosage requirement in a thiopurine methyltransferase-deficient child with acute lymphocytic leukemia1
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Evaluation of tolerance to mercaptopurine in patients with inflammatory bowel disease and gastrointestinal intolerance to azathioprine
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2022, Rheumatic Disease Clinics of North AmericaCitation Excerpt :Although the limited available studies are encouraging, further prospective trials are needed to better characterize the safe and effective AZA metabolite concentrations in children with rheumatic disease before specific dosing guidance is recommended. Screening for genetic variations in TPMT can identify patients at risk for myelotoxicity.117,118 In addition, up to 31% of patients preferentially produce 6-MMP instead of 6-TGN.119
Pharmacogenetics in Practice: Drug Management Amidst Rare Genomic Testing
2021, Journal for Nurse PractitionersCitation Excerpt :It is currently most often used in the field of oncology, but there are other fields gaining use. Early recognition of pharmacogenomics was identified in children with leukemia receiving 6-mercaptopurine; some children receiving this medication died due to a mutation in the metabolizing enzyme, thiopurine methyltransferase.3 In human immunodeficiency virus medicine, patients are screened for the HLA-B∗5701 gene before the initiation of highly active antiretroviral therapy due to the fact that abacavir can result in a life-threatening hypersensitivity reaction known as severe cutaneous adverse reaction in a subset of people.2
Pharmacogenomics and ALL treatment: How to optimize therapy
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Supported in part by Leukemia Program Project grant P01 CA-20180; MERIT award R37 04-36401, and Cancer Center CORE grant CA-21765, all from the National Cancer Institute; a Center of Excellence grant from the State of Tennessee; and the American Lebanese Syrian Associated Charities (ALSAC).