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What is Mercaptopurine?

By Maggie J. Hall
Updated May 17, 2024
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Oncologists frequently use mercaptopurine for the treatment of acute lymphocytic leukemia, commonly referred to as ALL. Physicians might also prescribe the purine antagonist medication as treatment for certain autoimmune disorders or blood cancers, including Chron’s disease, pediatric non-Hodgkin’s lymphoma and polycythemia vera. Adverse effects correlate with mercaptopurine’s destructive and immunosuppressant properties.

Cellular reproduction depends on the deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) codes contained within the nucleus that typically determines the rate of cell generation and the type of cell produced. When these codes become defective, abnormal cells develop or accelerated cell reproduction may occur. Researchers believe mercaptopurine interferes with the enzymes necessary for DNA and RNA coding, which inhibits abnormal cell proliferation. By impeding normal cellular activities, cell destruction occurs.

The bone marrow in patients diagnosed with acute lymphocytic leukemia and non-Hodgkin’s lymphoma rapidly produces abnormal white blood cells. Persons diagnosed with polycythemia vera have abnormally high red blood cell counts. Physicians might prescribe mercaptopurine in conjunction with other treatments to suppress development of these abnormal cells. Once patients enter remission, physicians often continue the medication to prevent the resurgence of anomalous cellular activity.

Scientists also believe that mercaptopurine interferes with the chemicals necessary to provide other immune responses. Health care providers frequently use a variety of medications including anti-inflammatory agents and antibiotics for the treatment of autoimmune inflammatory bowel diseases. When Chron’s disease or ulcerative colitis does not respond to normal treatment methods, health care providers might prescribe mercaptopurine to suppress abnormal immune responses.

A fraction of the patients suffering from psoriasis may develop an autoimmune disorder known as psoriatic arthritis. The disease commonly causes inflammation, swelling and abnormal growth of skin, connective and bone tissues. Health care providers often prescribe immunosuppressant medications similar to mercaptopurine to reduce these inflammatory processes and suppress accumulations of defective cellular growth.

The adverse effects of taking mercaptopurine are typically dependent on the dosage amount and the length of time patients use the medication. The longer the medication is used, the more severe the adverse effects. Side effects include appetite loss, hair loss and gastrointestinal symptoms. Patients may endure nausea, vomiting and diarrhea along with possible intestinal ulceration. Signs of anemia may occur as the drug also suppresses the development of healthy red and white blood cells and platelets.

Physicians might also prescribe medications that cause the urine to be more alkaline and recommend taking mecaptopurine with adequate amounts of water to prevent possible kidney malfunction. Problems arise because the blood filtering organs encounter higher than normal amounts of destroyed cells and purine. Patients might also experience destruction of liver tissue after prolonged use of the medication.

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