Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy

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) g...

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Autores principales: Belen, Burcu Fatma, Gürsel, Türkiz, Akyürek, Nalan, Albayrak, Meryem, Kaya, Zühre, Koçak, Ülker
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2014
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454056/
https://www.ncbi.nlm.nih.gov/pubmed/25541649
http://dx.doi.org/10.4274/tjh.2013.0082
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author Belen, Burcu Fatma
Gürsel, Türkiz
Akyürek, Nalan
Albayrak, Meryem
Kaya, Zühre
Koçak, Ülker
author_facet Belen, Burcu Fatma
Gürsel, Türkiz
Akyürek, Nalan
Albayrak, Meryem
Kaya, Zühre
Koçak, Ülker
author_sort Belen, Burcu Fatma
collection PubMed
description 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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spelling pubmed-44540562016-01-12 Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy Belen, Burcu Fatma Gürsel, Türkiz Akyürek, Nalan Albayrak, Meryem Kaya, Zühre Koçak, Ülker Turk J Haematol Case Report 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. Galenos Publishing 2014-12 2014-12-05 /pmc/articles/PMC4454056/ /pubmed/25541649 http://dx.doi.org/10.4274/tjh.2013.0082 Text en © Turkish Journal of Hematology, Published by Galenos Publishing. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Belen, Burcu Fatma
Gürsel, Türkiz
Akyürek, Nalan
Albayrak, Meryem
Kaya, Zühre
Koçak, Ülker
Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title_full Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title_fullStr Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title_full_unstemmed Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title_short Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy
title_sort severe myelotoxicity associated with thiopurine s-methyltransferase*3a/*3c polymorphisms in a patient with pediatric leukemia and the effect of steroid therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454056/
https://www.ncbi.nlm.nih.gov/pubmed/25541649
http://dx.doi.org/10.4274/tjh.2013.0082
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