RG, a 6-year-old child, has been diagnosed with Acute Lymphoblastic Leukemia (ALL). Thestandard treatment is 6-mercaptopurine (Purinethol), an inexpensive drug that inhibitsproliferation and is effective against rapidly proliferating cells like cancer cells. The compound isan antimetabolite that interferes with DNA synthesis. However, about 10% of patientsexperience life-threatening toxicities. 6-mercaptopurine is metabolized and detoxified by theenzyme thiopurine-S-methyltransferase (TPMT). The most common SNPS correlated with lowenzymatic activity are TPMT*3A, *3B, *3C and *2. They cause enhanced degradation of theenzyme. Genotyping reveals that RG has the following genotype: TPMT*3A/*2.Questions:1. A patient with low TPMT enzyme activity would:Accumulate 6-mercaptopurine and experience toxic side effectsMetabolize 6-mercaptopurine quickly and experience no anti-cancer benefits2. The gene encoding TPMT has been sequenced in RG: TPMT*3A/*2. The patient would beclassified as:poor metabolizernormal/extensive metabolizerrapid metabolizer3. Given the TPMT*3A/*2 genotype, what dose adjustment wouldyou recommend?Reduced doseNormal doseIncreased dose4. A patient with TPMT*1/*1 should receive what kind of dose?Reduced doseStandard doseIncreased dose

Multiple subparts are asked. I will answer 1st 3 subparts in the question, as per guidelines. Given…

Answered: RG, a 6-year-old child, has been…

Biochemistry

9th Edition

ISBN:9781319114671

Author:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Publisher:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Chapter1: Biochemistry: An Evolving Science

Section: Chapter Questions

Problem 1P

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