The accumulation of mercaptopurine metabolites in age fractionated red blood cells

1. Red blood cells from four children with lymphoblastic leukemia were age fractionated on Percoll density gradients into 'young', 'middle-aged' and 'old' cells. 2. The rates of accumulation of the mercaptopurine (MP) metabolites thioguanine nucleotides (TGNs) and methylmercaptopurine nucleotides (MeMPs) were measured in the cell fractions from the start of MP continuing chemotherapy. 3. TGNs and MeMP metabolites were present in all the red cell fractions after 3 days oral MP. There was no significant difference between the metabolite concentrations measured in either young, middle-aged or old cells (Mann-Whitney P = 1.0 to 0.12). 4. These observations suggest that MP metabolites do not enter red cells at the stem cell level at the start of therapy. 5. With respect to the monitoring of therapy, these results suggest that the concentration of TGNs after 7 to 10 days MP could be used to predict eventual steady-state concentrations using a simple model.