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Quantification of 6-Mercaptopurine and Its Metabolites in Patients with Acute Lympoblastic Leukemia Using Dried Blood Spots and UPLC-MS/MS

Department of Pharmacy, Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, Jakarta 13460, Indonesia
Faculty of Pharmacy, Universitas Indonesia, Kampus UI Depok, West Java 16424, Indonesia
Department of Research and Development of Dharmais Cancer Hospital, Jakarta 11420, Indonesia
Author to whom correspondence should be addressed.
Sci. Pharm. 2018, 86(2), 18;
Received: 2 April 2018 / Revised: 19 April 2018 / Accepted: 19 April 2018 / Published: 25 April 2018
PDF [981 KB, uploaded 3 May 2018]


This research aimed to quantitatively bioanalyze 6-mercaptopurine (6-MP), 6-methylmercaptopurine (6-MMP), and 6-thioguanosine-5′-monophosphate (6-TGMP) in dried blood spots (DBS) prepared from a small volume of acute lymphoblastic leukemia (ALL) patients. Analytes on the DBS card were extracted using 90% methanol with 5-fluorouracil (5-FU) as an internal standard. Analytical separation was performed on a Waters Acquity® UPLC BEH AMIDA column of 1.7 μm (2.1 × 100 mm) with a mobile phase mixture of 0.2% formic acid in water and 0.1% formic acid in acetonitrile-methanol, with gradient elution and a flow rate of 0.2 mL/min. Mass detection of 6-MP, 6-MMP, 6-TGMP, and 5-FU showed m/z values of 153.09 > 119.09, 167.17 > 126.03, 380.16 > 168.00, and 129.09 > 42.05, respectively. This DBS method had a run time of 5 min and yielded a linear calibration curve over a range of 25.5–1020 ng/mL for 6-MP, 6-MMP, and 6-TGMP. Analyte analysis in 22 of 24 ALL patients showed that the measured value of 6-TGMP as an active metabolite was in the range of 29–429 pmol/8 × 108 erythrocytes. Five of 22 patients had concentrations in a therapeutic range, which indicates that the treatment is effective, while 17 of 24 patients had concentrations below the therapeutic range, which indicates that a treatment dose adjustment is needed. The measured value of 6-MMP, an inactive metabolite, was in the range of 28–499 pmol/8 × 108 erythrocytes, which includes concentrations below the hepatotoxic range. The method employed here can thus be effectively utilized to support therapeutic drug monitoring. View Full-Text
Keywords: 6-mercaptopurine; dried blood spots; acute lymphoblastic leukemia 6-mercaptopurine; dried blood spots; acute lymphoblastic leukemia

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Supandi, S.; Harahap, Y.; Harmita, H.; Andalusia, R. Quantification of 6-Mercaptopurine and Its Metabolites in Patients with Acute Lympoblastic Leukemia Using Dried Blood Spots and UPLC-MS/MS. Sci. Pharm. 2018, 86, 18.

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