Improved HPLC methodology for monitoring thiopurine metabolites in patients on thiopurine therapy.
OBJECTIVE
Standardization of thiopurine metabolite testing is currently lacking. This paper presents in-depth methodological analysis and optimization of two currently available HPLC procedures (Lennard-Singleton [J. Chromatogr. 583 (1992) 83] and Dervieux-Boulieu [Clin. Chem. 44 (1998) 551]) to improve precision, turn-around time, ruggedness, and cost effectiveness.


METHODS
Reversed-phase chromatography with UV detection was performed on a Waters HPLC system. The two protocols were improved with regards to internal standardization (IS), chromatographic conditions, as well as reagent preparation, storage, and use. 6-Thioguanine nucleotides (6-TGNs) were analyzed by our optimized techniques in samples from patients on thiopurine therapy (n = 24) and the results were compared.


RESULTS
6-Mercaptopurine (6-MP) was an ideal internal standard in either procedure. Isocratic elution with 5% acetonitrile (ACN) in 20 mmol/l phosphate buffer pH 2.5 allowed for minimal background interference in both protocols. 6-Thioguanine, 6-mercaptopurine, and 6-methylmercaptopurine (6-MMP) eluted at around 4, 5, and 6 min, respectively. Dithiothreitol (DTT) was critical only during the acid hydrolysis step. Less mercury-containing waste was generated in the Lennard-Singleton procedure. With our optimized protocols recovery of 6-TGNs was on average 1.38-fold higher in the Dervieux-Boulieu method over a range of 10-678 pmol/8 x 10(8) RBC and no interfering peaks hindered analysis. Specific extraction of thiopurines before their analysis as per Lennard-Singleton procedure may be redundant.


CONCLUSIONS
We improved the quality and cost effectiveness of two known procedures for thiopurine metabolite assay. Through common chromatographic conditions and internal standardization, future comparison studies are now facilitated a great deal. The less tedious Dervieux-Boulieu procedure for routine thiopurine metabolite testing is warranted.
Stefan
Cristiana
C
Division of Clinical Biochemistry, Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada.
Walsh
Warren
W
Banka
Tibor
T
Adeli
Khosrow
K
Verjee
Zulfikarali
Z
D002851:Chromatography, High Pressure Liquid / Q000379:methods; D004229:Dithiothreitol / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D016014:Linear Models; D015122:Mercaptopurine / Q000031:analogs & derivatives* / Q000032:analysis / Q000097:blood / Q000378:metabolism*
C010240:6-methylthiopurine; D015122:Mercaptopurine; D004229:Dithiothreitol