mercaptopurine and Red-Cell-Aplasia--Pure

mercaptopurine has been researched along with Red-Cell-Aplasia--Pure* in 2 studies

Other Studies

2 other study(ies) available for mercaptopurine and Red-Cell-Aplasia--Pure

Article	Year
Allopurinol might improve response to azathioprine and 6-mercaptopurine by correcting an unfavorable metabolite ratio. Journal of gastroenterology and hepatology, 2011, Volume: 26, Issue:1 Allopurinol potentiates azathioprine and 6-mercaptopurine (6-MP) by increasing 6-thioguanine nucleotide (6-TGN) metabolite concentrations. The outcome might also be improved by adding allopurinol in individuals who preferentially produce 6-methylmercaptopurine nucleotides (6-MMPN), rather than 6-TGN. The aim of the present study was to investigate the effect of allopurinol on concentrations of 6-MMPN and 6-TGN in individuals with a high ratio of these metabolites (>20), which is indicative of a poor thiopurine response.. Sixteen individuals were identified who were taking azathioprine or 6-MP, and were commenced on allopurinol to improve a high 6-MMPN:TGN ratio. Metabolite concentrations were compared before and after commencing allopurinol, and markers of disease control were compared.. The addition of 100-300 mg allopurinol daily and thiopurine dose reduction (17-50% of the original dose) resulted in a reduction of the median (and range) 6-MMPN concentration, from 11,643 (3,365-27,832) to 221 (55-844) pmol/8×10(8) red blood cells (RBC; P=0.0005), increased 6-TGN from 162 (125-300) to 332 (135-923) pmol/8×10(8) RBC (P=0.0005), and reduced the 6-MMPN:6-TGN ratio from 63 (12-199) to 1 (0.1-4.5) (P=0.0005). There was a significant reduction in steroid dose requirements at 12 months (P=0.04) and trends for improvement in other markers of disease control. One patient developed red cell aplasia that resolved upon stopping azathioprine and allopurinol.. In those with a high 6-MMPN:6-TGN ratio (>20), response to thiopurine treatment might be improved by the addition of allopurinol, together with a reduced thiopurine dose and close hematological monitoring. Topics: Adult; Allopurinol; Anti-Inflammatory Agents; Azathioprine; Biotransformation; Drug Therapy, Combination; Enzyme Inhibitors; Erythrocyte Count; Female; Gastrointestinal Agents; Guanine Nucleotides; Humans; Inflammatory Bowel Diseases; Male; Mercaptopurine; Middle Aged; New Zealand; Red-Cell Aplasia, Pure; Retrospective Studies; Steroids; Thionucleotides; Time Factors; Treatment Outcome; Xanthine Oxidase	2011
Pure red cell aplasia associated with chronic myelomonocytic leukaemia. Clinical and laboratory haematology, 1989, Volume: 11, Issue:4 Topics: Aged; Blood Transfusion; Cyclophosphamide; Humans; Leukemia, Myelomonocytic, Chronic; Male; Mercaptopurine; Prednisone; Red-Cell Aplasia, Pure	1989

Article

Year

Allopurinol might improve response to azathioprine and 6-mercaptopurine by correcting an unfavorable metabolite ratio.

Journal of gastroenterology and hepatology, 2011, Volume: 26, Issue:1

Allopurinol potentiates azathioprine and 6-mercaptopurine (6-MP) by increasing 6-thioguanine nucleotide (6-TGN) metabolite concentrations. The outcome might also be improved by adding allopurinol in individuals who preferentially produce 6-methylmercaptopurine nucleotides (6-MMPN), rather than 6-TGN. The aim of the present study was to investigate the effect of allopurinol on concentrations of 6-MMPN and 6-TGN in individuals with a high ratio of these metabolites (>20), which is indicative of a poor thiopurine response.. Sixteen individuals were identified who were taking azathioprine or 6-MP, and were commenced on allopurinol to improve a high 6-MMPN:TGN ratio. Metabolite concentrations were compared before and after commencing allopurinol, and markers of disease control were compared.. The addition of 100-300 mg allopurinol daily and thiopurine dose reduction (17-50% of the original dose) resulted in a reduction of the median (and range) 6-MMPN concentration, from 11,643 (3,365-27,832) to 221 (55-844) pmol/8×10(8) red blood cells (RBC; P=0.0005), increased 6-TGN from 162 (125-300) to 332 (135-923) pmol/8×10(8) RBC (P=0.0005), and reduced the 6-MMPN:6-TGN ratio from 63 (12-199) to 1 (0.1-4.5) (P=0.0005). There was a significant reduction in steroid dose requirements at 12 months (P=0.04) and trends for improvement in other markers of disease control. One patient developed red cell aplasia that resolved upon stopping azathioprine and allopurinol.. In those with a high 6-MMPN:6-TGN ratio (>20), response to thiopurine treatment might be improved by the addition of allopurinol, together with a reduced thiopurine dose and close hematological monitoring.

Topics: Adult; Allopurinol; Anti-Inflammatory Agents; Azathioprine; Biotransformation; Drug Therapy, Combination; Enzyme Inhibitors; Erythrocyte Count; Female; Gastrointestinal Agents; Guanine Nucleotides; Humans; Inflammatory Bowel Diseases; Male; Mercaptopurine; Middle Aged; New Zealand; Red-Cell Aplasia, Pure; Retrospective Studies; Steroids; Thionucleotides; Time Factors; Treatment Outcome; Xanthine Oxidase

2011

Pure red cell aplasia associated with chronic myelomonocytic leukaemia.

Clinical and laboratory haematology, 1989, Volume: 11, Issue:4

Topics: Aged; Blood Transfusion; Cyclophosphamide; Humans; Leukemia, Myelomonocytic, Chronic; Male; Mercaptopurine; Prednisone; Red-Cell Aplasia, Pure

1989