Drug Fever Produced by Six-mercaptopurine

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Abstract
A patient with acute leukemia is described in whom oral 6-mercaptopurine produced a graded dose dependent pyrogenic response. The chiUs, fever and generalized malaise first appeared after 12 days of drug administration. The toxicity was sufficiently severe to necessitate cessation of this form of therapy. A pyrogenic reaction subsequently occurred when oral 6-chlorpurine was given and to a lesser extent after the administration of thioguanine. Adenine was without effect. "Tolerance" to the pyrogenic effect of the drug could not be induced by continued or increasing concentrations of 6-mercaptopurine. The intramuscular injection of the combined patients serum with 6-mercaptopurine into rabbits produced fever in the animals. No such effect was produced when either the patient''s serum alone, 6-mercaptopurine alone or a control serum was injected.

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