Thiopurines in current medical practice: molecular mechanisms and contributions to therapy-related cancer.
Thiopurines have diverse clinical applications and their long-term use as anti-rejection drugs in transplant patients has been associated with a significantly increased risk of various types of cancer. Although they are slowly being replaced by a new generation of non-thiopurine immunosuppressants, it is anticipated that their use in the management of inflammatory and autoimmune diseases will continue to increase. Therapy-related cancer will remain a potential consequence of prolonged treatment for these generally non-life-threatening conditions. Understanding how thiopurines contribute to the development of cancer will facilitate clinical decisions about the potential risks to patients of long-term treatment for chronic inflammatory disorders.
Karran
Peter
P
Cancer Research UK London Research Institute, Clare Hall Laboratories, South Mimms, Hertfordshire, EN6 3LD, UK. Peter.Karran@cancer.org.uk
Attard
Natalie
N
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D002273:Carcinogens; D002470:Cell Survival / Q000187:drug effects; D006801:Humans; D015122:Mercaptopurine / Q000627:therapeutic use*; D009369:Neoplasms / Q000188:drug therapy*; D011687:Purines / Q000627:therapeutic use*; D013438:Sulfhydryl Compounds / Q000627:therapeutic use; D013866:Thioguanine / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D002273:Carcinogens; D011687:Purines; D013438:Sulfhydryl Compounds; D015122:Mercaptopurine; D013866:Thioguanine; D001379:Azathioprine