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91745: Thiopurine Metabolites Print View
6-TG LC-MS-MS  235 - 400  pmol/8x10(8)RBC 
6-MMP LC-MS-MS  < 5700  pmol/8x10(8)RBC 

PRIMARY
1 Whole Blood EDTA 5 (2.5) mL   Room Temperature - 24 Hour(s)/Refrigerated - 5 Day(s)  
ALTERNATE

6-Mercaptopurine (Purinethol) and its imidazolyl derivative, Azathioprine (Imuran), are immunosuppressive drugs. 6-Mercaptopurine (6-MP) is indicated for remission induction and maintenance therapy of acute lymphoblastic leukemia (ALL). Azathioprine is indicated as an adjunct for the prevention of rejection in renal allograft (kidney transplant) patients, for the management of rheumatoid arthritis, and for the management of inflammatory bowel disease. Azathioprine is cleaved to 6-MP. 6-MP is metabolized via a series of enzymatic steps to 6-thioguanine nucleotides (6-TGNs), to 6-methyl-mercaptopurine (6-MMPNs) by the enzyme thiopurine methyltransferase (TPMT), and to 6-thiouric acid by the enzyme xanthine oxidase (XO). TPMT enzyme activity has large inter-individual variations which affect the efficacy, toxicity and variability of the treatment. Therapeutic drug monitoring of 6-MP metabolites (6-TGNs and 6- MMPNs) in erythrocytes is recommended to assist therapy, particularly in combination with TPMT enzyme activity or mutation analysis.

A trough specimen is required (within 1 hour prior to the next dose).
Setup Schedule
Tuesday-Saturday

Reported (Analytical Time)
Next day

CPT Code
80299

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Notes
Transport Temperature: Refrigerated Rejection Criteria:
Heparin whole blood; frozen; hemolysis

Methodology description:
Following the determination of the RBC concentration, the thiopurine metabolites 6-methylmercaptopurine (6-MMP) and 6-thioguanine (6-TG) are analyzed by LC/MS/MS in the red blood cells.






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