TPMT phenotype-sensitive
- TPMT activity strongly affects thiopurine tolerance
- Low activity → excessive active thioguanine nucleotides
- Severe myelosuppression can result
- Genotype/phenotype-guided starting dose is useful
- NUDT15 adds independent risk
Interaction at a glance
- TPMT activity strongly affects thiopurine tolerance
Mechanism
- TPMT activity strongly affects thiopurine tolerance
- Low activity → excessive active thioguanine nucleotides
Clinical consequence
- Severe myelosuppression can result
- NUDT15 adds independent risk
Management
- Genotype/phenotype-guided starting dose is useful
Self-check
- Key risk with TPMT phenotype-sensitive?
Severe myelosuppression can result. - Which gene adds risk independently of TPMT?
NUDT15.
Drugs in this interaction (2)
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