ArticleCancer research2009
Mutagenicity and potential carcinogenicity of thiopurine treatment in patients with inflammatory bowel disease.
Article in Cancer research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 52 citations in OpenAlex.
- Azathioprine versus mycophenolate mofetil for long-term immunosuppression in lupus nephritis: results from the MAINTAIN Nephritis Trial.Annals of the rheumatic diseases · 2010Trial
- Molecular analysis of somatic mutations at the HPRT locus in lymphocytes of human population exposed to chronic high background natural radiation.Scientific reports · 2026Article
- Review
- Risk Factors of All-Causes Mortality andArchives of Iranian medicine · 2025Article
- Myeloid neoplasms in inflammatory bowel disease: A case series and review of the literature.Leukemia research reports · 2024Review
- A Case Report of Follicular Lymphoma in a Crohn's Disease Patient Treated With Azathioprine.Cureus · 2023Article
- Diffuse large B-cell lymphoma in a patient treated with azathioprine for ulcerative colitis: a case report.Annals of medicine and surgery (2012) · 2023Article
- Colorectal Cancer in Ulcerative Colitis: Mechanisms, Surveillance and Chemoprevention.Current oncology (Toronto, Ont.) · 2022Review
- Oral Conventional Synthetic Disease-Modifying Antirheumatic Drugs with Antineoplastic Potential: a Review.Dermatology and therapy · 2022Review
- Thiopurines in Pediatric Inflammatory Bowel Disease: Current and Future Place.Paediatric drugs · 2020Review
- Hepatosplenic T-Cell Lymphoma: A Rare Complication of Monotherapy with Thiopurines in Crohn's Disease.GE Portuguese journal of gastroenterology · 2019Article
- Iatrogenic Kaposi sarcoma of the terminal ileum following short-term treatment with immunomodulators for Crohn disease: A case report.Medicine · 2019Article
- Understanding the Cautions and Contraindications of Immunomodulator and Biologic Therapies for Use in Inflammatory Bowel Disease.Inflammatory bowel diseases · 2017Review
- Oxidatively-generated damage to DNA and proteins mediated by photosensitized UVA.Free radical biology & medicine · 2017Review
- 9-Benzyl-6-benzyl-sulfanyl-9H-purin-2-amine.Acta crystallographica. Section E, Structure reports online · 2014Article
- Metastatic hepatocellular carcinoma in a patient with Crohn's disease treated with azathioprine and infliximab: a case report and literature review.Case reports in gastrointestinal medicine · 2014Article
- Thiopurines related malignancies in inflammatory bowel disease: local experience in Granada, Spain.World journal of gastroenterology · 2013Observational
- Development of a cost-effective high-throughput process of microsatellite analysis involving miniaturized multiplexed PCR amplification and automated allele identification.Human genomics · 2013Article
- Diagnosis and treatment of lupus nephritis flares--an update.Nature reviews. Nephrology · 2012Review
- Medical conditions and risk of adult myeloid leukemia.Cancer causes & control : CCC · 2012Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
The thiopurines azathioprine and 6-mercaptopurine (6-MP) are effective immune modulators and cytotoxic agents extensively used in the treatment of autoimmune diseases, graft rejection, and cancer. There is compelling epidemiologic evidence that thiopurine treatment increases the risk for a variety of tumors by mechanisms that are unclear. We investigated the in vivo mutagenicity of long-term thiopurine treatment by determining the frequency and spectra of somatic mutation events at the hypoxanthine phosphoribosyltransferase (HPRT) locus in peripheral T lymphocytes as well as the prevalence of mutant clonal proliferation in a cross-sectional analysis of data from 119 children and adults with inflammatory bowel disease (IBD). ANOVA and regression were performed to assess relationships among the frequency and spectra of HPRT mutations with disease, duration of illness, duration of treatment, and total therapeutic dose of azathioprine and 6-MP. We observed a significant increase in the frequency of somatic mutations in 56 subjects treated with thiopurines for IBD compared with 63 subjects not treated with thiopurines. This increase was related to both total dose (P < 0.001) and duration of treatment (P < 0.001). Comparative mutation spectra analysis of 1,020 mutant isolates revealed a significant increase in the proportion of all transitions (P < 0.001), particularly G:C to A:T transitions (P < 0.001). Combined analyses of two signatures for mutant clonality, HPRT mutation, and T-cell receptor beta CDR3 region unique gene sequence also showed a significant thiopurine-dependent increase in mutant cell clonal proliferation (P < 0.001). These findings provide in vivo evidence for mutation induction as a potential carcinogenic mechanism associated with chronic thiopurine intervention.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.