Open AccessSevere Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
Author(s) -
Burcu Belen,
Türkiz Gursel,
Nalân Akyürek,
Meryem Albayrak,
Zühre Kaya,
Ülker Koçak
Publication year - 2014
Publication title -
turkish journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.351
H-Index - 16
ISSN - 1300-7777
DOI - 10.4274/tjh.2013.0082
Subject(s) - medicine , thiopurine methyltransferase , pancytopenia , bone marrow suppression , mercaptopurine , bone marrow , pediatrics , gastroenterology , oncology , chemotherapy , azathioprine , disease
Myelosuppression is a serious complication during treatment of acute lymphoblastic leukemia and the duration of myelosuppression is affected by underlying bone marrow failure syndromes and drug pharmacogenetics caused by genetic polymorphisms. Mutations in the thiopurine S-methyltransferase (TPMT) gene causing excessive myelosuppression during 6-mercaptopurine (MP) therapy may cause excessive bone marrow toxicity. We report the case of a 15-year-old girl with T-ALL who developed severe pancytopenia during consolidation and maintenance therapy despite reduction of the dose of MP to 5% of the standard dose. Prednisolone therapy produced a remarkable but transient bone marrow recovery. Analysis of common TPMT polymorphisms revealed TPMT *3A/*3C.
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