mercaptopurine and Anemia--Aplastic

Topics: Adolescent; Adrenal Cortex Hormones; Alkylating Agents; Anemia; Anemia, Aplastic; Anemia, Hemolytic, Autoimmune; Antilymphocyte Serum; Arthritis, Rheumatoid; Autoimmune Diseases; Azathioprine; Colchicine; Cyclosporins; Danazol; Female; Hepatitis, Chronic; Humans; Immunoglobulin G; Immunosuppressive Agents; Levamisole; Lupus Erythematosus, Systemic; Male; Mercaptopurine; Methotrexate; Multiple Sclerosis; Pregnancy

Pure red cell aplasia is a selective aplasia of the marrow erythroid cells. Unlike aplastic anemia, the marrow has a normal cellularity and the patients generally have normal leukocyte and platelet blood counts. The congenital form of the disease occurs in the firlst 1 1/2 years of life and is often responsive to corticosteroids. The acquired form may be secondary to infections, drugs, chemicals, or hemolytic anemia (aplastic crisis). In these cases it is often acute and self-limited with cessation of the infection or drug ingestion. It may also be secondary to systemic lupus erythematosus, rheumatoid arthritis, acute severe renal failure, severe nutritional deficiency, or diverse neoplasms, and may remit with treatment of the primary condition. When a thymoma is present, it should be resected since a remission is produced in 29 per cent of these patients. The remaining patients have an acquired primary form of the disease that tends to be chronic and in some cases may have an immune pathogenesis. A cytotoxic immunoglobulin inhibitor of the marrow erythroid cells or erythropoietin has been described and these patients may respond to prednisone and/or to cytotoxic immunosuppressive drugs such as cyclophosphamide and 6-mercaptopurine. Pure red cell aplasia appears to be more common than the literature has revealed and has stimulated much investigation into an immune pathogenesis for marrow failure.

Topics: Acute Kidney Injury; Anemia, Aplastic; Antilymphocyte Serum; Arthritis, Rheumatoid; Blood Cell Count; Blood Transfusion; Cyclophosphamide; Deficiency Diseases; Erythropoietin; Humans; Immune System Diseases; Infections; Lupus Erythematosus, Systemic; Mercaptopurine; Prednisone; Remission, Spontaneous; Splenectomy; Thymoma; Thymus Neoplasms

Topics: Adult; Anemia, Aplastic; Animals; Antibodies, Antinuclear; Antigen-Antibody Complex; Bone Marrow; Bone Marrow Cells; Child, Preschool; Cyclophosphamide; Erythrocytes, Abnormal; Erythropoiesis; Erythropoietin; Heme; Humans; Immunoglobulin G; Infant; Mercaptopurine; Prednisone; Stimulation, Chemical; Thymectomy; Thymoma

Topics: Anemia; Anemia, Aplastic; Animals; Blood Transfusion; Bone Marrow; Bone Marrow Cells; Cell Differentiation; Chronic Disease; Erythropoiesis; Erythropoietin; Humans; Immune Sera; Kidney; Kidney Diseases; Lipids; Mercaptopurine; Polycythemia Vera

Topics: Adolescent; Anemia, Aplastic; Bone Marrow; Bone Marrow Cells; Child; Child, Preschool; Clinical Trials as Topic; Digestive System; Drug Combinations; Female; Humans; Leukemia, Myeloid, Acute; Leukopenia; Male; Mercaptopurine; Remission, Spontaneous; Triazines; Vincristine

A 6-year-old boy on maintenance chemotherapy for acute lymphocytic leukemia developed severe hypoplastic anemia during chemotherapy previously well tolerated. The hypoplastic episode persisted for approximately 30 days. Human parvovirus (B19), the etiologic agent of aplastic crisis in persons with underlying hemolytic syndromes, was detected in the patient's serum 25-30 days after onset of hemoglobin decrease, and B19 IgM seroconversion occurred 1 week later. The patient's hypoplastic anemia was presumably caused by prolonged B19 infection resulting from a blunted immune response. An immune response to the B19 infection and resolution of the illness were temporally associated with brief cessation of chemotherapy.

Topics: Anemia, Aplastic; Antineoplastic Agents; Child; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Parvoviridae Infections; Prednisone; Vincristine

Fanconi anemia (FA) fibroblasts are known to be exceptionally sensitive to the cytotoxic action of mitomycin C (MMC). The survival of FA cells was enhanced significantly when 0.5 mM caffeine or 0.5 mM adenine was added for 72 h after the cells were exposed to MMC. In other experiments in which MMC was not used, FA fibroblasts were shown to be significantly more sensitive than control cells to 6-mercaptopurine (6-MP), 6-thioguanine (6-TG), and 6-azauridine (6-AU). These observations offer a new approach to defining the basic biochemical defect in FA.

Topics: Anemia, Aplastic; Ataxia Telangiectasia; Azauridine; Cell Survival; Cells, Cultured; Dose-Response Relationship, Drug; Fanconi Anemia; Humans; Mercaptopurine; Mitomycins; Skin; Thioguanine

Acquired erythroblastic aplasia of adults is a rare disease characterised by the absence of red cell precursors in the bone marrow. In a 34-year-old female patient the disease has been known for seven years. A partial remission had at first been achieved with glucocorticoids but regular transfusions had been necessary since 1971. Treatment with cyclophosphamide produced a remission which has lasted for over twelve months up to now. Histology of the bone marrow biopsy shows the appearance of active erythropoiesis after cyclophosphamide treatment which reflects well the clinical course.

Topics: Adult; Anabolic Agents; Anemia, Aplastic; Antibody Formation; Antilymphocyte Serum; Azathioprine; Cyclophosphamide; Female; Humans; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; T-Lymphocytes; Testosterone; Vitamin B 12

Topics: Adolescent; Adult; Aged; Androgens; Anemia, Aplastic; Azathioprine; Chronic Disease; Cyclophosphamide; Glucocorticoids; Humans; Immunoglobulin G; Iron; Male; Mercaptopurine; Middle Aged; Vitamins

Topics: Agranulocytosis; Anemia, Aplastic; Anti-Bacterial Agents; Antineoplastic Agents; Asparaginase; Blood Platelets; Blood Transfusion; Cytarabine; Daunorubicin; Drug Therapy, Combination; Hemorrhage; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocytes; Mercaptopurine; Methotrexate; Prednisone; Thrombocytopenia; Vincristine

Topics: Anemia, Aplastic; Autoimmune Diseases; Bone Marrow; Bone Marrow Cells; Female; Fluorescent Antibody Technique; Humans; Immunoglobulin G; Immunosuppressive Agents; Mercaptopurine; Middle Aged; Remission, Spontaneous

Topics: Anemia, Aplastic; Azathioprine; Cyclophosphamide; Hemangiosarcoma; Humans; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Skin Neoplasms; Thymoma; Thymus Gland; Thymus Neoplasms

Topics: Adult; Anemia, Aplastic; Benzene; Environmental Exposure; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Occupational Diseases; Shoes

Topics: Adolescent; Anemia, Aplastic; Antineoplastic Agents; Central Nervous System; Child; Child, Preschool; Cyclophosphamide; Daunorubicin; Diarrhea; Drug Combinations; Female; Follow-Up Studies; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Nausea; Pneumonia, Pneumocystis; Prednisone; Radiotherapy; Recurrence; Remission, Spontaneous; Stomatitis, Aphthous; Vincristine; Vomiting

Topics: Adolescent; Allopurinol; Anemia, Aplastic; Drug Synergism; Humans; Male; Mercaptopurine

Topics: Adolescent; Adult; Aged; Alopecia; Ampicillin; Anemia, Aplastic; Antibiotics, Antineoplastic; Blood Platelets; Blood Transfusion; Cardiomyopathies; Cephaloridine; Electrocardiography; Female; Heart; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Paresthesia; Remission, Spontaneous; Sulfamethoxazole; Thrombocytopenia; Trimethoprim

Topics: Aged; Anemia, Aplastic; Antineoplastic Agents; Blood Transfusion; Bone Marrow Examination; Busulfan; Hemorrhagic Disorders; Humans; Leukemia, Myeloid; Male; Megakaryocytes; Mercaptopurine; Mitosis; Prednisone

Topics: Anemia, Aplastic; Antibodies, Antinuclear; Azathioprine; Bone Marrow; Cyclophosphamide; Erythropoiesis; Heme; Humans; Immunosuppressive Agents; In Vitro Techniques; Male; Mercaptopurine; Middle Aged; Muscular Diseases; Prednisone; Splenectomy; Thymectomy; Thymoma

Topics: Anemia, Aplastic; Azathioprine; Hematopoiesis; Hematopoietic System; Humans; Immunosuppressive Agents; Leukopenia; Mechlorethamine; Mercaptopurine; Time Factors

Topics: Anemia, Aplastic; Blood Transfusion; Bone Marrow Cells; Cell Count; Erythrocytes, Abnormal; Erythropoiesis; Humans; Infant; Male; Mercaptopurine; Prednisolone; Reticulocytes; Time Factors

Topics: Anemia, Aplastic; Erythrocytes, Abnormal; Humans; Infant; Male; Mercaptopurine

Topics: Anemia, Aplastic; Antibiotics, Antineoplastic; Antineoplastic Agents; Azirines; Bronchial Neoplasms; Drug Synergism; Fluorouracil; Humans; Hydrazines; Injections, Intramuscular; Injections, Intravenous; Lectins; Lung Neoplasms; Mechlorethamine; Mercaptopurine; Methotrexate; Pleural Neoplasms; Vinblastine

Topics: Adolescent; Adult; Aged; Anemia, Aplastic; Antibiotics, Antineoplastic; Bone Marrow Examination; Child; Child, Preschool; Cyclophosphamide; Drug Synergism; Female; Humans; Infections; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Middle Aged; Patient Isolators; Prednisone; Vincristine

Topics: Adolescent; Adult; Anemia, Aplastic; Biopsy; Child; Female; Humans; Kidney; Leukopenia; Lupus Erythematosus, Systemic; Male; Mercaptopurine; Microscopy, Electron; Nephrotic Syndrome; Proteinuria; Thrombocytopenia

Topics: Anemia; Anemia, Aplastic; Bone Marrow; Humans; Leukemia; Mercaptopurine