High TMPT Activity

Patients with leukemia and high (> 12 U/mL) TPMT activity are at risk for a disease relapse despite conventional maintenance 6-MP dosing (Bostrom and Erdman, 1993). In these patients, 6-MP metabolism is believed to be shunted away from the production of 6-TG ribonucleotides and into the preferential formation of 6-MMP metabolites (McCleod et al, 1995). In patients with IBD, a recent retrospective study has shown that patients with TPMT enzyme activity levels > 14 U/mL blood were more likely to be refractory to AZA therapy (Ansari et al, 2002). A recent prospective open-labeled study showed that patients with TPMT < 15.3 U/mL of blood were 6.3 times more likely to respond to induction AZA therapy (Cuffari et al, 2004). Patients with very high (> 5700 pmoles/8 x 108 RBCs) erythrocyte 6-MMP levels and presumably high TPMT enzyme activity have also been shown to be at an increased risk for hepatotoxicity (Dubinsky et al, 2002).

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.

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