Concluding Remarks

The high-performance liquid chromatography measurement of erythrocyte 6-MP metabolites has now become a useful clinical tool for documenting patients' compliance to therapy as well as the adequacy of dosing. Ongoing studies have developed the notion of a therapeutic window of efficacy and toxicity based on the measure of erythrocyte 6-TG and 6-MMP levels. Moreover, prior knowledge of a patient's erythrocyte TPMT enzyme activity may allow physicians to tailor the dosage of either AZA or 6-MP to suite a patient's individual drug metabolism. Those with very low (< 5 U/mL) TPMT activity can be effectively treated (90% response) with 1 mg/kg/d while monitoring complete blood counts and erythrocyte 6-TG levels. Whereas patients with TPMT activity between 5 to 12 U/mL blood show a 70% response rate to a moderate dosing strategy, such as 1.5 mg/kg/d. In patients with above average (> 12 U/mL) TPMT activity, AZA may need to be started at 2.0 mg/kg/d in order to achieve a 40% clinical response. However, higher dosages, such as 2.5 mg/kg/d, are expected to be needed for those with very high (> 20 U/mL) TPMT enzyme activity. In these patients, the careful monitoring of 6-TG and 6-MMP levels may help to guide therapy and identify those patients that preferentially shunt AZA metabolites away from the production of 6-TG, (Cuffari et al, 2004).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

Get My Free Ebook


Post a comment