Abstract
Thiopurine methyltransferase (TPMT) activity exhibits monogenic co-dominant inheritance, with ethnic differences in the frequency of occurrence of variant alleles. With conventional thiopurine doses, homozygous TPMT-deficient patients (~1 in 178 to 1 in 3,736 individuals with two nonfunctional TPMT alleles) experience severe myelosuppression, 30-60% of individuals who are heterozygotes (~3-14% of the population) show moderate toxicity, and homozygous wild-type individuals (~86-97% of the population) show lower active thioguanine nucleolides and less myelosuppression. We provide dosing recommendations (updates at http://www.pharmgkb.org) for azathioprine, mercaptopurine (MP), and thioguanine based on TPMT genotype.
Originalsprog | Engelsk |
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Tidsskrift | Clinical Pharmacology and Therapeutics |
Vol/bind | 89 |
Udgave nummer | 3 |
Sider (fra-til) | 387-91 |
Antal sider | 5 |
ISSN | 0009-9236 |
DOI | |
Status | Udgivet - mar. 2011 |