Thiopurines in current medical practice: molecular mechanisms and contributions to therapy-related cancer

Nat Rev Cancer. 2008 Jan;8(1):24-36. doi: 10.1038/nrc2292.


Thiopurines have diverse clinical applications and their long-term use as anti-rejection drugs in transplant patients has been associated with a significantly increased risk of various types of cancer. Although they are slowly being replaced by a new generation of non-thiopurine immunosuppressants, it is anticipated that their use in the management of inflammatory and autoimmune diseases will continue to increase. Therapy-related cancer will remain a potential consequence of prolonged treatment for these generally non-life-threatening conditions. Understanding how thiopurines contribute to the development of cancer will facilitate clinical decisions about the potential risks to patients of long-term treatment for chronic inflammatory disorders.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Azathioprine / therapeutic use*
  • Carcinogens
  • Cell Survival / drug effects
  • Humans
  • Mercaptopurine / therapeutic use*
  • Neoplasms / drug therapy*
  • Purines / therapeutic use*
  • Sulfhydryl Compounds / therapeutic use
  • Thioguanine / therapeutic use*


  • Antineoplastic Agents
  • Carcinogens
  • Purines
  • Sulfhydryl Compounds
  • Mercaptopurine
  • Thioguanine
  • Azathioprine