Bradley P P, Warden G D, Maxwell J G, Rothstein G
Ann Intern Med. 1980 Oct;93(4):560-2. doi: 10.7326/0003-4819-93-4-560.
Hematologic toxicity occurred when trimethoprim-sulfamethoxazole was given for prolonged periods to renal allograft subjects also treated with azathioprine. In six such patients, the incidences and duration of neutropenia and thrombocytopenia were greater than in 25 similar allograft recipients treated with azathioprine alone. In bone marrow culture, the antifolate action of trimethoprim-sulfamethoxazole enhanced the marrow-suppressive effect of 6-mercaptopurine, the active moiety cleaved from azathioprine. These studies show that in renal allograft recipients treated with azathioprine, the prolonged use of trimethoprim-sulfamethoxazole may result in life-threatening hematotoxicity.
当给予接受硫唑嘌呤治疗的肾移植受者长期服用复方新诺明时，会发生血液学毒性。在6例此类患者中，中性粒细胞减少和血小板减少的发生率及持续时间均高于25例单独接受硫唑嘌呤治疗的类似移植受者。在骨髓培养中，复方新诺明的抗叶酸作用增强了从硫唑嘌呤裂解出的活性部分6-巯基嘌呤的骨髓抑制作用。这些研究表明，在接受硫唑嘌呤治疗的肾移植受者中，长期使用复方新诺明可能导致危及生命的血液毒性。
