The Treatment of Autoimmune Hemolytic Anemia with 6-Mercaptopurine and Thioguanine

Fourteen patients with autoimmune hemolytic anemia were treated with either 6-mercaptopurine or thioguanine. Nine patients responded and five failed to improve. Eight patients developed side effects, either hematologic or gastrointestinal, of varying degrees of severity; in three the antimetabolite had to be discontinued, while in others adjustment of the dosage or the administration of antacids was sufficient to control side effects. Included in this series are nine patients who failed to respond adequately to corticosteroid therapy; four of these had a good effect from antimetabolite therapy.

Although these results indicate that antimetabolites may reverse the course of autoimmune hemolytic anemia, the eventual role of these agents in the treatment of this disorder requires further study.