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TPMT, or thiopurine S-methyltransferase, plays a crucial role in pharmacogenetics by influencing how individuals metabolize thiopurine medications used in the treatment of certain cancers, autoimmune diseases, and organ transplants. Variations in the TPMT gene can lead to either rapid or slow metabolism of these drugs, impacting their effectiveness and risk of toxicity. Understanding a patient’s TPMT genotype is invaluable for clinicians in dosing thiopurine drugs safely and effectively. Personalized treatment plans based on TPMT genetic testing can optimize therapeutic benefits while minimizing adverse reactions, such as bone marrow suppression.