mercaptopurine / Generic mfg. - LARVOL DELTA

Implementing Pre-Emptive Pharmacogenetics: Impact of Early Pharmacogenetic Screening in a Pediatric Oncology Cohort of 1,151 Subjects. (PubMed, Clin Pharmacol Ther) - "While comprehensive pharmacogenetic guidelines are not yet available for all anticancer drugs, evidence-based recommendations exist for a subset of supportive care drugs and anticancer drugs, including thiopurines, irinotecan, capecitabine, and 5-fluorouracil...These include dose and treatment recommendations for allopurinol, nonsteroidal anti-inflammatory drugs, phenytoin, amitriptyline, proton pump inhibitors, voriconazole, tramadol, codeine, paroxetine, tacrolimus, rasburicase, and 6-mercaptopurine...Leveraging genetic profiles to guide clinicians in drug selection and dose optimization can improve patient outcomes by enhancing the safety and efficacy of treatments. We therefore recommend incorporating pharmacogenetic screening into clinical workflows to advance personalized medicine in pediatric oncology."

Biomarker • Journal • Oncology • Pediatrics

Degradable Metal-Small Molecule Drug Coordination Nanomedicines for DNA Damage-Augmented Cancer Chemodynamic Therapy. (PubMed, Small) - "The design is achieved by the coordination-driven self-assembly of Cu2+ and 6-mercaptopurine (6-MP) with the siAPE1 loading and hyaluronic acid (HA) modification...In vivo, experiments demonstrate the remarkable therapeutic efficacy against A549 lung cancer in mice with negligible systemic toxicity after intravenous administration of the siAPE1/Cu-MP@HA. This study offers an innovative approach targeting the DNA damage repair system for enhancing CDT effects in cancer treatment."

Journal • Lung Cancer • Oncology • Solid Tumor

Haploinsufficiency of A20: Investigating Expanded Phenotypes, Immune Dysregulation, and Liver Injury in a Rare Autoinflammatory Syndrome (CIS 2025) - "She has residual vision loss, spinal cord atrophy with lower extremity weakness, and neurogenic bladder, but she is now 22, and tofacitinib controls her oral ulcers, rashes, and arthritis. Her mother, age 61 and on hydroxychloroquine for her lupus, has a sister who also carries the family variant and has been diagnosed with adult-onset Still's disease. The patient with hepatitis and cytopenias, the daughter of the unaffected carrier, responded well to 6-mercaptopurine for her liver disease and rituximab for arthritis and rash. However, she subsequently developed fatal pulmonary hypertension age 16, in the absence of parenchymal lung disease.Thiscaseseriesprovidesimportant insights into HA20,highlighting its diverse clinical presentations and emphasizing the importance of liver injury as a potential phenotype. The breadth of phenotypes in HA20 combined with incomplete penetrance likely contributes to under recognition of this monogenic cause of complex immune..."

Cardiovascular • CNS Disorders • Hematological Disorders • Hepatology • Immunology • Inflammation • Inflammatory Arthritis • Liver Failure • Lupus • Nephrology • Neuromyelitis Optica Spectrum Disorder • Pulmonary Arterial Hypertension • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Rheumatology • Systemic Lupus Erythematosus • TNFAIP3

The Vulnerability of the Heart During Diarrhea: A Case Report on Pericarditis Linked to Inflammatory Bowel Disease. (PubMed, J Community Hosp Intern Med Perspect) - "This case is particularly noteworthy due to the complexity added by the patient's 24-year history of UC, diverse treatment modalities (including mesalamine, 6-mercaptopurine, infliximab, vedolizumab, upadacitinib, and ustekinumab), and the patient not being on any 5-aminosalicylic acid (5-ASA) medications known to cause pericarditis at the time of presentation...The patient's pericarditis was managed with corticosteroids and colchicine, leading to rapid symptom resolution...This report highlights the need for heightened awareness and careful management of pericarditis in UC patients. Clinicians should maintain a high index of suspicion for cardiovascular complications in IBD, ensuring timely diagnosis and intervention."

Journal • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Pain • Ulcerative Colitis

Ileocolic Anastomotic Reconstruction Techniques in Ileocolic Crohn's Disease: A SingleInstitution Experience (ASCRS 2025) - "At 1-year follow-up, all patients were on medication for Crohn's, mainly ustekinumab (43.5%), vedolizumab (20.5%), adalimumab (15.4%), infliximab (15.4%), and mercaptopurine (2.6%). Although the intubation rate was the same for TI, our study was not able to account for difficulty of intubation. Longer follow-up with endoscopic and clinical recurrence is needed to confirm these findings."

Clinical • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease • Novel Coronavirus Disease

Testing the Addition of the Anti-cancer Drug Venetoclax and/or the Anti-cancer Immunotherapy Blinatumomab to the Usual Chemotherapy Treatment for Infants With Newly Diagnosed KMT2A-rearranged or KMT2A-non-rearranged Leukemia (clinicaltrials.gov) - P2 | N=153 | Recruiting | Sponsor: National Cancer Institute (NCI) | Not yet recruiting ➔ Recruiting

Enrollment open • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology

Unveiling the Uncommon: A Case of Spontaneous Fungal Peritonitis in Autoimmune Hepatitis (ATS 2025) - "Case Description A 20-year-old woman with Ehlers-Danlos syndrome, Type 1 diabetes mellitus, autoimmune hepatitis, and recent pancytopenia attributed to 6-mercaptopurine (6-MP) use presented with abdominal pain and fever. She was started on meropenem for neutropenic fever and subsequently transferred to our institution for liver transplant evaluation...6-MP was discontinued, growth-colony stimulating factor (G-CSF) and leucovorin rescue therapy were initiated, and pan-susceptible Escherichia Coli cleared in subsequent blood cultures...Initially, the patient was switched to fluconazole, but due to worsening septic shock, micafungin was restarted...While spontaneous bacterial peritonitis is well-recognized and promptly treated, SFP remains under-recognized. Current literature indicates that antifungal initiation within 48 hours only minimally improves prognosis, highlighting the challenges of source control and the necessity of early and aggressive intervention."

Clinical • Autoimmune Hepatitis • Diabetes • Febrile Neutropenia • Fibrosis • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Cirrhosis • Metabolic Disorders • Ocular Infections • Ocular Inflammation • Ophthalmology • Pain • Pneumonia • Respiratory Diseases • Septic Shock • Type 1 Diabetes Mellitus

Examining APOBEC3B in TCGA and ICGC breast cancer datasets reveals altered drug metabolism pathways (AACR 2025) - "Notably, the tamoxifen regulatory pathway was altered in high A3B-expressing tumors, which showed reduced expression of CYP2D6 and CYP3A10...Additionally, pathways related to uracil synthesis, involving drugs such as 5-fluorouracil and 6-mercaptopurine, were downregulated in tumors with high A3B expression...Conversely, such tumors might exhibit increased susceptibility to treatments like 5-fluorouracil. Evaluating the functional consequences of A3B expression in breast cancers could pave the way for strategies to modulate A3B activity, enhancing the efficacy of existing therapies and mitigating drug resistance."

Breast Cancer • HER2 Breast Cancer • HER2 Positive Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • APOBEC3B • CYP2D6 • HER-2

Efficacy of tioguanine and mycophenolate mofetil as second-line immunosuppressive treatment in autoimmune hepatitis management (EASL 2025) - "Background and Aims: Azathioprine or 6-mercaptopurine is commonly used as a first-line maintenance treatment in the management of autoimmune hepatitis (AIH). This is the first study comparing tioguanine against MMF in AIH management. Both tioguanine and MMF had high and comparable efficacy in achieving biochemical remission in AIH patients as a second-line agent. Tioguanine was well tolerated even in patients intolerant to azathioprine and may perform better than MMF in patients with inadequate response to first-line treatment."

Clinical • Autoimmune Hepatitis • Gastrointestinal Disorder • Hepatology • Immunology • Inflammation • Inflammatory Bowel Disease

Long term efficacy, effectiveness and side effects of third line therapies in autoimmune hepatitis (EASL 2025) - "Ninety patients (96.8%) received steroid maintenance therapy (12% budesonide; 88% prednisolone). Sixty-six patients (71%) were treated with azathioprine (AZA); 46 discontinued due to side effects, 13 due to lack of efficacy, one achieved remission. Nine patients were treated with mercaptopurine (MP) (10.1%) as first/second line therapy; all of whom discontinued due to side effects...Mycophenolate mofetil (MMF) was initiated in 68 patients (73.1%)...Rituximab was administered to six patients (6.5%)... In this single-centre cohort, primarily comprising difficult-to-treat AIH patients, third-line therapies demonstrated favourable long-term clinical outcomes with significant improvement in biochemical parameters, prolonged clinical event-free survival, and a good safety profile."

Adverse events • Clinical • Autoimmune Hepatitis • Cervical Cancer • CNS Disorders • Gynecology • Hematological Disorders • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Immunology • Inflammation • Nephrology • Oncology • Renal Disease • Solid Tumor • Vasculitis

Incidence of Myocarditis Caused by Drugs Used for Ulcerative Colitis as Examined Using VigiBase, a Spontaneous Adverse Drug Reaction Reporting Database. (PubMed, Biol Pharm Bull) - "We searched for adverse event signals of five drugs, mesalazine, sulfasalazine, azathioprine, mercaptopurine, and budesonide, listed in the treatment guidelines for UC, using VigiBase. Our results also indicate that UC itself may induce myocarditis. Our findings warrant multifaceted investigations, including basic and clinical studies, on the characteristics of each drug regarding the development of myocarditis as an adverse event."

Adverse drug reaction • Journal • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

ECOG-ACRIN E1910: Combination Chemotherapy With or Without Blinatumomab in Treating Patients With Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P3 | N=488 | Active, not recruiting | Sponsor: National Cancer Institute (NCI) | Trial completion date: Mar 2025 ➔ Mar 2026

Trial completion date • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology • ABL1 • CD4 • CDKN2A • ETV6 • IGH • PBX1 • RUNX1 • TCF3

MAINTENANCE THERAPY POST ANTI CD19 CHIMERIC ANTIGEN RECEPTOR(CAR) T CELL THERAPY – A SINGLE CENTRE PILOT STUDY (EBMT 2025) - "Few studies have explored the options of using maintenance with 6 Mercaptopurine (6 MP) for B ALL and Acalabrutinib for B NHL after CAR T as a consolidation strategy to reduce relapse risk.We report our single center experience on the use of maintenance therapy post CAR T and the feasibility and safety of this approach...For B cell ALL, 6 MP was given in a dose targeting myelosuppression with white cell count of 1500 to 3000/microliter except 1 patient with Philadelphia positive with T315I mutation who was given Ponatinib and for B cell NHL, Acalabrutinib was started at dose of 100mg once daily and increased as per tolerance... We found in our study that maintenance therapy after CAR T cell is low cost with acceptable safety profile. Longer follow up is required before its wider applicability and consideration as a feasible choice for consolidation in these high risk individuals."

Clinical • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • B Cell Non-Hodgkin Lymphoma • Bone Marrow Transplantation • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Lymphoma • Neutropenia • Non-Hodgkin’s Lymphoma • Oncology

Long-term outcome of using Ara-C or not in children's APL. (PubMed, Blood Sci) - "All patients received all-trans retinoic acid (ATRA) + arsenic trioxide (ATO) induction therapy, followed by the course of idarubicin (IDA) and ATO, then were randomly allocated to 2 groups for consolidation therapy, with patients in the daunorubicin (DNR) group received DNR, in the DNR + Ara-C (DA) group received DNR + Ara-C. Maintenance therapy consisted of oral ATRA, 6-mercaptopurine, and methotrexate for 1.5 years...Our study found no prognostic significance of Ara-C, this may be related to the small sample size. We still recommend the addition of Ara-C during treatment, which has a more positive impact on early remission and late prognosis of patients."

Journal • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • Pediatrics

Asparaginase Erwinia Chrysanthemi With Chemotherapy for the Treatment of High-Risk Adults With Newly Diagnosed Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma (clinicaltrials.gov) - P2 | N=53 | Not yet recruiting | Sponsor: City of Hope Medical Center

New P2 trial • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Lymphoma • Oncology • Pediatrics

Tagraxofusp and Low-Intensity Chemotherapy for the Treatment of CD123 Positive Relapsed or Refractory Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma (clinicaltrials.gov) - P1/2 | N=4 | Terminated | Sponsor: M.D. Anderson Cancer Center | Trial completion date: Jul 2025 ➔ Jul 2024 | Active, not recruiting ➔ Terminated | Trial primary completion date: Jul 2025 ➔ Jul 2024; Administratively Complete 75%< Participants

Trial completion date • Trial primary completion date • Trial termination • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • T Acute Lymphoblastic Leukemia • IL3RA

Pharmacological evaluation of drug therapies in Aicardi-Goutières syndrome: insights from patient-derived neural stem cells. (PubMed, Front Pharmacol) - "Among thiopurines, thioguanine, but not mercaptopurine, exhibited cytotoxicity in NSCs...Interestingly, high concentrations of certain JAK inhibitors (ruxolitinib, baricitinib, tofacitinib) led to an unexpected increase in cell viability in AGS patient-derived cells compared to control, suggesting potential alterations in cell proliferation or stress responses...These findings suggest that glucocorticoids, JAK inhibitors (excluding pacritinib), and RTIs are likely safe for NSCs of AGS patients, while caution is warranted with thioguanine and pacritinib. Further studies are needed to explore the mechanisms underlying increased cell viability at high JAK inhibitor concentrations and the selective sensitivity to zidovudine."

Journal • Aicardi Goutieres Syndrome • Genetic Disorders • Interferonopathies

Polyostotic Langerhans cell histiocytosis presenting as halitosis in a 24-year-old man: a case report. (PubMed, J Med Case Rep) - "This reveals the vitality of the early diagnosis of Langerhans cell histiocytosis to prevent disease progression. Awareness of diverse and nonpathognomonic manifestations of Langerhans cell histiocytosis, proper medical interview and history taking, and the use of routine radiographs may aid clinicians in lowering morbidity and mortality rates associated with such conditions."

Journal • Dental Disorders • Infectious Disease • Langerhans Cell Histiocytosis • Novel Coronavirus Disease • Oncology • Rare Diseases • Respiratory Diseases • CD1a

IRON OVERLOAD CARDIOMYOPATHY: AN OVERLOOKED COMPLICATION OF CANCER THERAPIES - Sara Diaz Saravia (ACC 2025) - "However, Iron Overload Cardiomyopathy (IOC) remains an under-diagnosed yet reversible cause of cardiomyopathy in cancer patients.Case: An 88-year-old male with history of coronary artery disease, sick sinus syndrome requiring pacemaker, myelodysplastic syndrome with progression to acute lymphoblastic leukemia (ALL) being treated with mercaptopurine, azacitidine and prednisone presented with rest angina triggered by episodes of anemia when hemoglobin decreased below 8 mg/dl...Medical therapy was optimized with sacubitril-valsartan, empagliflozin, and beta blockers... While cardiotoxicity of anti-cancer therapies is often attributed to chemotherapy, radiation or immunotherapy, IOC can be an overlooked cause of cancer-therapy related cardiovascular dysfunction. It should be considered as a differential diagnosis for patients requiring frequent blood transfusions, and can be reversed without chelation therapy."

Acute Lymphocytic Leukemia • Anemia • Cardiomyopathy • Cardiovascular • Coronary Artery Disease • Hematological Disorders • Hematological Malignancies • Leukemia • Myelodysplastic Syndrome • Oncology • Otorhinolaryngology • Pain • Pulmonary Disease

AUTOLOGOUS STEM CELL TRANSPLANTATION VERSUS MAINTENANCE THERAPY AS A POST-CONSOLIDATION THERAPY IN PATIENTS WITH STANDARD RISK ACUTE LYMPHOBLASTIC LEUKEMIA (EBMT 2025) - "Background: According to the recommendations of the Polish Adult Leukemia Group (PALG) patients (pts) with standard risk (SR) acute lymphoblastic leukemia (ALL) after one induction and three consolidation therapy should be treated with either autologous stem cell transplantation (ASCT) followed by reduced maintenance therapy consisted of 6-mercaptopurine (MP), methotrexate (MTX) +/- rituximab (RIT) or proceed to maintenance therapy (MP, MTX, vincristine and daunorubicin, prednisone +/- RIT) without transplantation. The treatment of SR-ALL patients according to the PALG recommendations results in satisfying 5-year OS of about 75%. There are no differences in the main treatment outcomes between ASCT and maintenance therapy used after third consolidation in this group of patients."

Clinical • Acute Lymphocytic Leukemia • Bone Marrow Transplantation • Hematological Disorders • Hematological Malignancies • Hepatology • Infectious Disease • Leukemia • Oncology • T Acute Lymphoblastic Leukemia • Transplantation • KMT2A

AUTOLOGOUS STEM CELL TRANSPLANTATION VERSUS MAINTENANCE THERAPY AS A POST-CONSOLIDATION THERAPY IN PATIENTS WITH STANDARD RISK ACUTE LYMPHOBLASTIC LEUKEMIA (EBMT 2025) - "Background: According to the recommendations of the Polish Adult Leukemia Group (PALG) patients (pts) with standard risk (SR) acute lymphoblastic leukemia (ALL) after one induction and three consolidation therapy should be treated with either autologous stem cell transplantation (ASCT) followed by reduced maintenance therapy consisted of 6-mercaptopurine (MP), methotrexate (MTX) +/- rituximab (RIT) or proceed to maintenance therapy (MP, MTX, vincristine and daunorubicin, prednisone +/- RIT) without transplantation. The treatment of SR-ALL patients according to the PALG recommendations results in satisfying 5-year OS of about 75%. There are no differences in the main treatment outcomes between ASCT and maintenance therapy used after third consolidation in this group of patients."

Clinical • Acute Lymphocytic Leukemia • Bone Marrow Transplantation • Hematological Disorders • Hematological Malignancies • Hepatology • Infectious Disease • Leukemia • Oncology • T Acute Lymphoblastic Leukemia • Transplantation • KMT2A

Case report: Inflammatory bowel disease in Hermansky-Pudlak syndrome type 3 due to novel variant in HPS3. (PubMed, Front Genet) - "The patient was treated with corticosteroids and mercaptopurine for management of IBD symptoms and has been attending follow-up appointments. Currently, the patient is in clinical remission; however, there remains a potential risk of relapse. We present a rare case of HPS-related IBD resulting from a homozygous variant in HPS3 and provide insights into the understanding of the diagnosis and treatment of HPS3."

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ophthalmology • Pain

B-cell Acute Lymphoblastic Leukemia Presenting as Acute Liver Injury: A Case Report. (PubMed, Cureus) - "The patient was treated with steroid therapy for HLH, followed by chemotherapy and immunotherapy for B-cell acute lymphoblastic leukemia, leading to sustained remission and normalization of liver function. Thirteen months after diagnosis, the patient remains in good health and continues blinatumomab-prednisone, vincristine, 6-mercaptopurine, and methotrexate consolidation therapy."

Journal • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Disorders • Hematological Malignancies • Hemophagocytic lymphohistiocytosis • Hepatology • Immunology • Leukemia • Liver Failure • Oncology • Rare Diseases

Testing the Combination of Inotuzumab Ozogamicin and Lower Dose Chemotherapy Compared to Usual Chemotherapy for Adults With B-Cell Acute Lymphoblastic Leukemia or B-Cell Lymphoblastic Lymphoma (clinicaltrials.gov) - P2 | N=68 | Active, not recruiting | Sponsor: Alliance for Clinical Trials in Oncology | Recruiting ➔ Active, not recruiting

Enrollment closed • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Lymphoma • Oncology • CD20 • CD22

UKALL14: Standard Chemotherapy with or Without Nelarabine or Rituximab in Treating Patients with Newly Diagnosed Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P=N/A | N=0 | Completed | Sponsor: University College, London | Active, not recruiting ➔ Completed | N=1033 ➔ 0 | Trial completion date: Dec 2025 ➔ Feb 2025

Enrollment change • Trial completion • Trial completion date • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Mucositis • Oncology • Stomatitis • ABL1 • BCR • MYC