Search results for "mercaptopurine"
showing 10 items of 18 documents
Designer Thiopurine-analogues for Optimised Immunosuppression in Inflammatory Bowel Diseases.
2015
Background and Aims: The clinical use of azathioprine and 6-mercaptopurine is limited by their delayed onset of action and potential side effects such as myelosuppression and hepatotoxicity. As these drugs specifically target the Vav1/Rac1 signalling pathway in T lamina propria lymphocytes via their metabolite 6-thio-GTP, we studied expression and optimised suppression of this pathway in inflammatory bowel diseases [IBD]. Methods: Rac1 and Vav1 expressions were analysed in mucosal immune cells in IBD patients. Targeted molecular modelling of the 6-thio-GTP molecule was performed to optimise Rac1 blockade; 44 modified designer thiopurine-analogues were tested for apoptosis induction, potenti…
Splenic Littoral Cell Hemangioendothelioma in a Patient With Crohn's Disease Previously Treated With Immunomodulators and Anti-TNF Agents: A Rare Tum…
2011
Th e risk of malignancy in Crohn ’ s disease (CD) has been well described. Moreover, immunomodulators, uch as azathioprine (AZA) and 6-mercaptopurine (6-MP), and biological agents, such as infl iximab and adalimumab, may promote carcinogenesis ( 1 – 3 ). Splenic littoral cell tumors are recently described tumors of vascular origin composed of endothelial cells, with typical microscopic and immunohistochemical features of splenic sinus lining cells ( 4 ). Clinical findings are not specific, and outcome is unpredictable but usually benign, although a few cases with a malignant behavior have been reported ( 5,6 ). We report a 58-year-old Caucasian man with a long history of ileocolonic CD.
Switching to a Second Thiopurine in Adult and Elderly Patients With Inflammatory Bowel Disease: A Nationwide Study From the ENEIDA Registry
2020
Abstract Background and Aims Although commonly used in inflammatory bowel disease [IBD], thiopurines frequently cause intolerance, and switching to a second thiopurine has only been reported in some small series. Ours aims in this study were to evaluate the safety of switching to a second thiopurine in a large cohort, and to assess the impact of age on tolerance. Methods Adult IBD patients from the ENEIDA registry, who were switched to a second thiopurine due to adverse events [excluding malignancies and infections], were identified. At the beginning of thiopurine treatment, patients were divided by age into two groups: 18–50 and over 60 years of age. The rate and concordance of adverse eve…
Tolerability profile of thiopurines in inflammatory bowel disease: a prospective experience
2017
The occurrence of thiopurine-related adverse events (AEs) may complicate the management of patients with inflammatory bowel disease (IBD). We aimed to evaluate the tolerability of thiopurines in a current IBD setting.All consecutive patients who started a treatment with azathioprine (AZA) from January 2010 to March 2016 were entered in a prospectively maintained database, and the AEs which led to the permanent discontinuation of the drug were reported.Two hundred and fifty three patients were included. Median total follow-up was 32 months (range: 0.2-75 months). At the end of the study, AZA was discontinued in 160 patients (63.2%). The main reason leading to drug withdrawal was the occurren…
Thiopurine adherence: high prevalence with low impact in UC outcomes
2021
Introduction Thiopurines are used as maintenance therapy in patients with ulcerative colitis (UC). There are contradictory results regarding the relationship between adherence to treatment and risk of relapse. Objectives To quantify and evaluate the trends in thiopurines prescription rates, and to determine the impact and risk factors of non-adherence. Methods Analytical, observational and retrospective study of UC patients, on thiopurines, included in the ENEIDA single-center registry from October 2017 to October 2019. We included adult patients under clinical remission at the beginning of the study on thiopurines maintenance treatment for at least 6 months before recruitment. Adherence wa…
Excess primary intestinal lymphoproliferative disorders in patients with inflammatory bowel disease.
2012
International audience; BACKGROUND: It remains to be shown whether inflammatory bowel disease (IBD) is associated with an increased risk of primary intestinal lymphoproliferative disorders (PILD). We assessed this risk in the CESAME French nationwide prospective observational cohort. METHODS: In all, 680 gastroenterologists enrolled 19,486 patients with IBD (Crohn's disease in 60.3%) from May 2004 to June 2005. Follow-up ended on 31 December 2007. Available biopsy samples and surgical specimens from patients with PILD (n = 14) were centralized for review. The reference incidence of PILD in the general population was obtained from the Côte d'Or registry and was used as a comparator to assess…
Symptomatic hypoglycemia in children receiving oral purine analogues for treatment of childhood acute lymphoblastic leukemia
2002
Background Antimetabolite-based continuation therapy is commonly used for childhood acute lymphoblastic leukemia (ALL) and hypoglycemia after prolonged fasting has been recently reported. We have found that spontaneous, symptomatic hypoglycemia (SH) may also occur in such patients. Procedure Between 1995 and 1999, patients treated according to the AIEOP-ALL-95 study received BFM-type intensive chemotherapy; mercaptopurine (6-MP) was given (60 mg/m2/days, orally for 14 days) during the second part of induction and during consolidation therapy (25 mg/m2/day, orally for 8 weeks); thioguanine (6-TG) was given during reinduction therapy with protocol II (60 mg/m2/day, orally for 14 days); contin…
Comparison of the immunosuppressive efficacy of 6-mercaptopurine, azathioprine, cyclophosphamide and 036.5122 (Asta) on the primary and secondary imm…
1976
Two alkylating (cyclophosphamide and 036.5122 Asta) and two antiproliferative agents (6-mercaptopurine and azathioprine) have been compared for their immuno-suppressive potency on the primary and secondary humoral immune response of mice. If equitoxic dosages of the respective drugs are compared, the alkylating agents proved to be of much higher immunosuppressive potency than the antiproliferative agents. In non toxic dosages alkylating agents were able to completely inhibit a primary or secondary immune response, whilst a similar effect with antiproliferative drugs could not be obtained even within toxic dose ranges. Induction of immunological tolerance was possible only by use of the alky…
Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols
2020
PETHEMA, HOVON, PALG, GATLA cooperative groups.
Prediction of leukocyte counts during paediatric acute lymphoblastic leukaemia maintenance therapy
2019
Maintenance chemotherapy with oral 6-mercaptopurine and methotrexate remains a cornerstone of modern therapy for acute lymphoblastic leukaemia. The dosage and intensity of therapy are based on surrogate markers such as peripheral blood leukocyte and neutrophil counts. Dosage based leukocyte count predictions could provide support for dosage decisions clinicians face trying to find and maintain an appropriate dosage for the individual patient. We present two Bayesian nonlinear state space models for predicting patient leukocyte counts during the maintenance therapy. The models simplify some aspects of previously proposed models but allow for some extra flexibility. Our second model is an ext…