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Immune hemolytic anemia induced by 6‐mercaptopurine
Author(s) -
Pujol M.,
Fernández F.,
Sancho J.M.,
Ribera J.M.,
Millá F.,
Feliu E.
Publication year - 2000
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2000.40010075.x
Subject(s) - hemolysis , coombs test , medicine , hemolytic anemia , anemia , immunology , immune system , antimetabolite , mercaptopurine , chemotherapy , chronic lymphocytic leukemia , autoimmune hemolytic anemia , leukemia , drug , gastroenterology , methotrexate , pharmacology , antibody
BACKGROUND: Myelosuppression is the main hematotoxic effect of 6‐mercaptopurine (6‐MP), which is an antimetabolite chemotherapy drug. Immune hemolytic anemia associated with this drug has not been previously reported. CASE REPORT: A 67‐year‐old man with chronic myelomonocytic leukemia presented with anemia 2 weeks after 6‐MP therapy had been initiated. Additional tests provided laboratory evidence of hemolysis. When treatment was stopped, the patient's condition and laboratory results showed a progressive improvement. RESULTS: The direct antiglobulin test was positive for IgG. The eluate and the serum were not reactive with panel red cells but reacted with 6‐MP‐treated red cells, while the normal serum pool was unreactive. The direct antiglobulin test was no longer positive by 20 days after the cessation of 6‐MP therapy. CONCLUSION: This drug, 6‐MP, should be added to the list of drugs that have been reported to cause immune hemolytic anemia by means of the so‐called hapten mechanism.