mercaptopurine / Generic mfg. - LARVOL DELTA

Network-based discovery of tumor-checkpoint inverter drugs targeting pancreatic ductal adenocarcinoma cell states and macrophage reprogramming (AACR 2026) - "Cross-model validation identified state-specific candidate drugs, including Leuprolide, Vinblastine, and Mercaptopurine for GLS; Vindesine, Gossypol, and Binimetinib for MOS; and AT9283, Crizotinib, and Afatinib for PLS. Predicted MR-inversion scores correlated with experimental dose-response profiles in cell lines selected via OncoMatch.Together, these results establish a mechanistic link between tumor-intrinsic transcriptional states and macrophage immunosuppression, while identifying mutation-agnostic, state-specific drugs capable of reprogramming both tumor and immune compartments. This work provides a generalizable framework for network-based drug repurposing to overcome transcriptional plasticity and immune resistance in PDAC."

Oncology • Pancreatic Ductal Adenocarcinoma • APOE

Solvation-mediated isomerization of surface motifs tunes emissions and electron transfer dynamics in gold nanoclusters. (PubMed, Nat Commun) - "Here, we report the solvation-triggered isomerization of surface terminations and modulation of electron transfer dynamics in the 6-mercaptopurine-9-β-D-ribofuranoside (6-MPR)-protected gold NCs, to attain a controllable emission spanning widely from 495 nm sky-blue to 800 nm near-infrared light...The further solvation of gold NCs is rationally designed by mapping out fourteen different organic solvents into four categories referring to their inherent properties of viscosity, polarity, coordination ability, and the strength of proton-giving capacity. This allows for rational conversion between R1 and R2 domains, and is concurrent with modulation of the proton-coupled electron transfer dynamics and thus customizable emission tuning."

Journal

Early Toxicity in Childhood Acute Lymphoblastic Leukemia: A Comparison of NOPHO ALL2008 and ALLTogether Protocols in Sweden. (PubMed, Pediatr Blood Cancer) - P, P3, P3/4 | "The early introduction of asparaginase likely contributed to increased weight gain, hyperglycemia, and osteonecrosis. While overall toxicity burden remained similar between protocols, the shift in toxicity profile may explain the perception of increased early toxicity during treatment with the ALLTogether protocol."

Journal • Acute Lymphocytic Leukemia • Diabetes • Hematological Malignancies • Hepatology • Leukemia • Liver Failure • Oncology • Pediatrics

Capizzi Escalating Methotrexate Versus High Dose Methotrexate in Children With Newly Diagnosed T-cell Lymphoblastic Lymphoma (T-LBL) (clinicaltrials.gov) - P3 | N=200 | Recruiting | Sponsor: Children's Cancer Group, China | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial primary completion date • Hematological Malignancies • Lymphoma • Oncology

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 | Recruiting | Sponsor: City of Hope Medical Center | Suspended ➔ Recruiting

Enrollment open • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Lymphoma • Oncology • Pediatrics • CD20

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 | Suspended | Sponsor: City of Hope Medical Center | Recruiting ➔ Suspended

Trial suspension • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Lymphoma • Oncology • Pediatrics • CD20

Nationwide epidemiologic and economic burden analysis of neurologic disorders associated with cancer treatment (AACR 2026) - "Higher mean incremental daily dose was significantly associated with increased CIND hazard, with oral agents showing HRs per 1-SD from 1.09-2.23 (bexarotene, capecitabine, hydroxyurea, mercaptopurine, tretinoin; all p≤0.046) and IV methotrexate showing HR 1.34 (95% CI 1.00-1.79; p=0.048). In this nationwide cohort, CIND is common, often delayed, and shaped by route of administration, indication, dose intensity, and patient comorbidity. CIND care concentrates substantial utilization and financial burden in chemotherapy exposed populations, underscoring the need for dose optimized regimens, proactive surveillance, and better supportive care strategies."

Clinical • HEOR • Oncology

Prospective Collaborative Study for Pulse Dexamethasone and Lenalidomide in Relapsed/Refractory Langerhans Cell Histiocytosis (LENDEX-LCH Study): INPHOG-HIST-19-03 (CTRI/2020/07/026937). (PubMed, Pediatr Blood Cancer) - "LENDEX is well tolerated and effective in 73% children with relapsed/refractory LCH. Future studies would include nine cycles of LENDEX followed by maintenance for 12 months with 6-mercaptopurine."

Journal • Hematological Disorders • Langerhans Cell Histiocytosis • Musculoskeletal Pain • Oncology • Orthopedics • Pain • Pediatrics • Pulmonary Disease • Respiratory Diseases

6-mercaptopurine and tofacitinib alter microbial protein expression but not composition in fecal microbiota incubations from Crohn's disease patients. (PubMed, BMC Biol) - "Tofacitinib and especially 6-MP significantly affect microbial function, but barely microbial composition in vitro. These drug-induced functional changes may subsequently influence host physiology and potentially inflammation in CD. Our findings emphasize the relevance to include functional microbial studies when investigating drug-microbiota interactions. Further research is needed to elucidate the impact of 6-MP-induced microbial alterations on intestinal physiology and inflammation in CD."

Journal • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease

EFFECT OF MINIMAL RESIDUAL DISEASE GUIDED POSTTRANSPLANT 6-MERCAPTOPURINE AND METHOTREXATE MAINTENANCE ON PROGNOSIS OF HIGH-RISK PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA: A SINGLE-CENTER EXPERIENCE (EBMT 2026) - "To our knowledge, this is the first pediatric study to assess preemptive, flow-MRD-guided 6-MP/MTX maintenance after allo-SCT in high-risk ALL. This approach to relapse prevention in pediatric ALL may enhance survival with minimal toxicity and low cost; nevertheless, further research is needed for a full assessment of these potential approaches."

Clinical • Minimal residual disease • Post-transplantation • Residual disease • Acute Graft versus Host Disease • Acute Lymphocytic Leukemia • Graft versus Host Disease • Hematological Malignancies • Immunology • Leukemia • Pediatrics • Transplantation

EFFECT OF MINIMAL RESIDUAL DISEASE GUIDED POSTTRANSPLANT 6-MERCAPTOPURINE AND METHOTREXATE MAINTENANCE ON PROGNOSIS OF HIGH-RISK PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA: A SINGLE-CENTER EXPERIENCE (EBMT 2026) - "To our knowledge, this is the first pediatric study to assess preemptive, flow-MRD-guided 6-MP/MTX maintenance after allo-SCT in high-risk ALL. This approach to relapse prevention in pediatric ALL may enhance survival with minimal toxicity and low cost; nevertheless, further research is needed for a full assessment of these potential approaches."

Clinical • Minimal residual disease • Post-transplantation • Residual disease • Acute Graft versus Host Disease • Acute Lymphocytic Leukemia • Graft versus Host Disease • Hematological Malignancies • Immunology • Leukemia • Pediatrics • Transplantation

T-CELL ACUTE LYMPHOBLASTIC LEUKEMIA RELAPSE AFTER CAR-T THERAPY (EBMT 2026) - "Background: Tisagenlecleucel (formerly CTL019), an anti-CD19 chimericantigen receptor (CAR) T-cell therapy, is an establishedtreatment for pediatric patients with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL)...Prior to CAR-T therapy, the patient received multiple chemotherapy regimens, including RE-ALL (with a measurable residual disease [MRD] of 38.36% at the end of induction phase 2), cytarabine and etoposide, hyper-CVAD, and blinatumomab (post-treatment bone marrow MRD of 59.7% blasts)...The patient underwent lymphodepletion with fludarabine (120 mg/m²) and cyclophosphamide (1000 mg/m²), followed by the first CAR-T cell infusion...The topotecan regimen was repeated, and a second CAR-T cell infusion was administered...A new treatment regimen with vincristine and PEG-asparaginase was initiated, followed by three doses of inotuzumab...Currently, six months after relapse, the patient remains on low-dose methotrexate and mercaptopurine, with..."

CAR T-Cell Therapy • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Bone Marrow Transplantation • Hematological Malignancies • Inherited Retinal Dystrophy • Leukemia • Ophthalmology • T Acute Lymphoblastic Leukemia • T-cell Acute Lymphoblastic Lymphoma

Optimizing mercaptopurine therapy in indian pediatric ALL: The role of TPMT and NUDT15 genetic polymorphisms. (PubMed, Cancer Treat Res Commun) - "This evaluation indicates that NUDT15 variations are more prevalent than TPMT among Indian patients. Consequently, the genotyping of TPMT and NUDT15 before MP treatment may assist in determining the appropriate dosage of MP to prevent life-threatening infections."

Journal • Review • Acute Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Leukopenia • Oncology • Pediatrics • NUDT15 • TPMT

NCI-2021-09185: Venetoclax and a Pediatric-Inspired Regimen for the Treatment of Newly Diagnosed B Cell Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P1 | N=24 | Recruiting | Sponsor: City of Hope Medical Center | Trial completion date: Feb 2026 ➔ May 2026 | Trial primary completion date: Feb 2026 ➔ May 2026

Trial completion date • Trial primary completion date • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology • Pediatrics

Characterizing pharmacist impact in maintenance therapy for adolescent and young adults with acute lymphoblastic leukemia treated with CALGB 10403 protocol. (PubMed, J Oncol Pharm Pract) - "During Course V maintenance, patients receive mercaptopurine (6MP) and oral methotrexate (MTX), which require frequent laboratory monitoring and dose adjustments. With the addition of a second pharmacist in the leukemia clinic, the monthly rate of pharmacist-led dose holds and modifications for 6MP and MTX increased by over four-fold.ConclusionPharmacists played a significant role in the safe administration of 6MP and MTX, particularly with the addition of a second clinic pharmacist. This study demonstrates the value of pharmacist involvement in optimizing patient safety during treatment of ALL."

Journal • Acute Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • Pediatrics

PHARMACOGENETIC MARKERS IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA THERAPY. (PubMed, Exp Oncol) - "In particular, pharmacogenetic markers for the following drugs were analyzed: anthracyclines (doxorubicin, daunorubicin), vincristine, glucocorticoids (prednisone, dexamethasone), L-asparaginase, methotrexate, alkylating agents (cyclophosphamide, ifosfamide), 6-mercaptopurine, cytarabine, and etoposide. At present, only a few genes, TPMT and NUDT15, have well-established clinical utility, whereas the clinical relevance of pharmacogenetic markers for other drugs used in pediatric ALL therapy remains under investigation. The review also highlights the main knowledge gaps in current research and outlines promising directions for future studies aimed at integrating pharmacogenetic testing into clinical practice for personalized treatment of ALL."

Biomarker • Journal • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • Pediatrics • NUDT15

SWOG-S1318: Blinatumomab and Combination Chemotherapy or Dasatinib, Prednisone, and Blinatumomab in Treating Older Patients With Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P2 | N=53 | Active, not recruiting | Sponsor: National Cancer Institute (NCI) | Trial completion date: Jun 2026 ➔ Jan 2027

Trial completion date • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology • T Acute Lymphoblastic Leukemia • ABL1 • BCR • CD4 • CSF1R • FGFR • PDGFRA • PDGFRB

AALL1521: A Phase 2 Study of Ruxolitinib With Chemotherapy in Children With Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P2 | N=171 | Completed | Sponsor: Incyte Corporation | Active, not recruiting ➔ Completed

Trial completion • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • T Acute Lymphoblastic Leukemia • CRLF2 • EPOR • IL7R • JAK1 • JAK2 • SH2B3

IntReALL BCP 2020 International Study for Treatment of Childhood Relapsed Precursor B-cell ALL 2020 (clinicaltrialsregister.eu) - P2/3 | N=765 | Not yet recruiting | Sponsor: Charite Universitaetsmedizin Berlin KR

New P2/3 trial • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • CD22

PHARMACOGENOMIC ASSOCIATIONS OF TPMT AND NUDT15 WITH THIOPURINE-INDUCED TOXICITY ACROSS CLINICAL SETTINGS: A SYSTEMATIC REVIEW (ISPOR 2026) - "OBJECTIVES: Thiopurines, including azathioprine, 6-mercaptopurine, and 6-thioguanine, are widely used in the management of inflammatory bowel disease, autoimmune disorders and selected malignancies. This systematic review highlights the clinical significance of TPMT and NUDT15 pharmacogenomics in predicting thiopurine-induced toxicity, especially within IBD populations. Evidence in oncology remains limited. Adding pharmacogenomic testing may enhance thiopurine safety, although further high-quality studies are needed."

Biomarker • Clinical • Review • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Leukopenia • Neutropenia • NUDT15

Acquired Immunodeficiency in Newborn Following Intrauterine Exposure to Thiopurines for Treatment of Inflammatory Bowel Disease. (PubMed, ACG Case Rep J) - "Thiopurines, azathioprine and 6-mercaptopurine (6-MP), have not been identified as teratogenic in humans and are considered safe to use during pregnancy. Here, we present 3 infants who developed severe lymphopenia secondary to prenatal exposure. Clinicians should be aware of this uncommon but potentially severe side effects."

Journal • Gastroenterology • Gastrointestinal Disorder • Human Immunodeficiency Virus • Immunology • Inflammation • Inflammatory Bowel Disease

Modified LCH-III Regimen With or Without Luvometinib for Multisystem Pediatric Langerhans Cell Histiocytosis (clinicaltrials.gov) - P=N/A | N=120 | Recruiting | Sponsor: West China Second University Hospital

New trial • Langerhans Cell Histiocytosis • Pediatrics

A041501: Inotuzumab Ozogamicin and Frontline Chemotherapy in Treating Young Adults With Newly Diagnosed B Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P3 | N=310 | Suspended | Sponsor: Alliance for Clinical Trials in Oncology | Trial completion date: Aug 2026 ➔ Aug 2027 | Trial primary completion date: Mar 2026 ➔ Mar 2027

Trial completion date • Trial primary completion date • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology • ABL1 • BCR • CD20 • CD22 • ITGB1

Marek's disease virus hijacks host nucleotide metabolism via UL23-mediated c-Myc activation. (PubMed, Vet Microbiol) - "Functional assays revealed that adenine and guanine supplementation enhanced MDV replication, while the purine inhibitor 6-mercaptopurine (6MP) suppressed it...Additionally, MDV thymidine kinase UL23 was identified as crucial in reprogramming nucleotide metabolism, promoting c-Myc-mediated nucleotide anabolism and viral replication. This research highlights the potential of targeting nucleotide metabolism as an antiviral strategy."

Journal • Infectious Disease • MYC

Exploring the gut microbiome and metabolomic interactions of antimetabolite drugs to optimize therapy. (PubMed, Gut Microbes) - "This review synthesizes the effects of common antimetabolites (including 5-fluorouracil, methotrexate, gemcitabine, capecitabine, 6-mercaptopurine, and thioguanine) on gut microbial communities and outlines a framework (pharmacokinetics, endogenous metabolite production, immune modulation, and apoptotic pathway modulation) for assessing chemotherapy-microbiota interactions. Additionally, potential microbial biomarkers for predicting treatment responses and strategies for manipulating the gut microbiota to enhance therapeutic efficacy are discussed. Therefore, advances in methodologies such as metagenomics and real-time microbial monitoring will be essential for unraveling these interactions and promoting the precise application of antimetabolite drugs."

Journal • Review • Immune Modulation • Immunology • Oncology