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My wife (LRP4 MG) took Imuran and developed severe anemia. It inhibits RBC production in the bone marrow from what I read. They monitored her hemoglobin where “normal” is 12 or so. When it dropped under 10 then under 9 they started taking blood tests more often. When she got to under 7 they gave her transfusions. She had several which was concerning from a safety point but also she was very tired all the time from low RBC. When she took Rituxan and it helped her immediately they took her off of all other MG meds within 2-3 months including Imuran. Her hemoglobin went straight back to normal very quickly and has remained there ever since. Just be aware that you can get anemic from Imuran and test for it.