The VAMP program (vincristine, amethopterin, 6-mercaptopurine
, and prednisone) raised leukemia remission rates to 60 percent by the end of the decade, and at least half the time these remissions were measured in years.
MacDonald, "Azathioprine or 6-mercaptopurine
for maintenance of remission in Crohn's disease," Cochrane Database of Systematic Reviews, vol.
Food and Drug Administration (FDA) has been aggressive in providing genetic labeling on new drugs, and also updating product labels for a number of existing therapies, such as warfarin and 6-mercaptopurine
. At present, some 120 drugs (9) have pharmacogenetics information in their FDA product label.
Fraser et al, 2002 Adverse effects of Ulcerative colitis azathioprine in the 6-mercaptopurine
treatment of inflammatory bowel disease Martinez et al, 2001 Adverse events of 6-mercaptopurine
thiopurine Smoking immunomodulators in patients with inflammatory bowel disease.
Azathioprine is a prodrug that is metabolized rapidly to 6-mercaptopurine
and is safe to be used as immunosuppression in pregnancy, even though it has been listed a class D drug by FDA.
Medical therapy includes mesalamine, steroids, 5-aminosalicylate, 6-mercaptopurine
, azathioprine, infliximab, and thiopurines.
Patients taking 6-mercaptopurine
with xanthine oxidase inhibitors may experience cellular toxicity, as these drugs inhibit the metabolism of 6-mercaptopurine
by the enzyme thiopurine methyltransferase, raising its plasma concentration.
Patients who reached CR were treated with consolidation chemotherapy, which contains several regimens such as high-dose methotrexate (MTX) (2 g?m [sup]-2?d [sup]-1 , day 1), CAM (CY 750 mg?m [sup]-2?d [sup]-1 , days 1 and 15; arabinoside cytarabine (Ara-C) 200 mg?m [sup]-2?d [sup]-1 , days 1-3 and 8-10; 6-mercaptopurine
60 mg?m [sup]-2?d [sup]-1 , generally 100 mg/d, p.o., days 1-7), dexamethasone (DOAME) 0.15 mg?kg [sup]-1?d [sup]-1 , days 1-5; VCR 1.4 mg?m [sup]-2?d [sup]-1 , maximum 2 mg/d, day 1; Ara-C 2 g?m [sup]-2?d [sup]-1 , days 1-3; mitoxantrone 8 mg?m [sup]-2?d [sup]-1 , days 2 and 3; etoposide 0.1 g/d, days 3-5), etc.
It has been most commonly reported after intravenous use of chemotherapeutic agents such as 5-fluorouracil, docetaxel and combinations of methotrexate, cytosine arabinoside, daunorubicin, 6-mercaptopurine
, cyclophosphamide, doxorubicin, bleomycin, vinka alkaloids and dacarbazine.
Predisposing Drugs Antituberculosis agents: Isoniazid Pyrazinamide Antiepileptic drugs: Hydantoins Ethionamide Phenobarbital Diazepam Chemotherapy and immunosuppressive drugs 6-Mercaptopurine
5-Fluorouracil Chlorambucil Azathioprine Chloramphenicol
He remained symptomatic, and oral 6-mercaptopurine
, 50 mg once a day, was prescribed.
Grotegut and his associates at Duke most commonly use azathioprine and 6-mercaptopurine
A 6-year-old male child with standard-risk group B-cell acute lymphoblastic leukemia (ALL) was being treated according to BFM-2002, in the maintenance phase of a chemotherapeutic regimen that included methotrexate and 6-mercaptopurine
was admitted to our hospital complaining of small grouped maculopapular lesions on an erythematous base.
Children were defined as having IBD if they had either three or more health care visits for Crohn's disease or ulcerative colitis during the study's time frame, or "at least one health care contact for Crohn's disease or ulcerative colitis and at least one pharmacy claim for any of the following medications: mesalamine, olsalazine, balsalazide, sulfasalazine, 6-mercaptopurine
, azathioprine, methotrexate, enteral budesonide, or biologies (infliximab, adalimumab, certolizumab, or natalizumab)."
* azathioprine, 6-mercaptopurine
and antitumour necrosis factor.