mercaptopurine / Generic mfg. - LARVOL DELTA

Relationship Between Thiopurine S-Methyltransferase Genotype and Phenotype in Pediatric Acute Lymphoblastic Leukemia in Addis Ababa, Ethiopia. (PubMed, J Pediatr Pharmacol Ther) - "This study showed that the commonly genotyped variants in TPMT are rare in pediatric acute lymphoblastic leukemia patients from Ethiopia."

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

AALL1821: A Study to Compare Blinatumomab Alone to Blinatumomab With Nivolumab in Patients Diagnosed With First Relapse B-Cell Acute Lymphoblastic Leukemia (B-ALL) (clinicaltrials.gov) - P2 | N=461 | Recruiting | Sponsor: National Cancer Institute (NCI) | Suspended ➔ Recruiting | N=300 ➔ 461

Enrollment change • Enrollment open • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Developmental Disorders • Genetic Disorders • Hematological Malignancies • Leukemia • Oncology • CD19

Interventions to prevent postoperative recurrence of crohn's disease: a systematic review and meta-analysis (BSG 2025) - "Only mesalamine or sulfasalazine (RR 0.88, 0.67, 1.14; n=6); infliximab (RR 0.38; 0.17, 0.86; n=4); probiotics (RR 0.98, 0.67, 1.42; n=4); antibiotics or antimicrobials (RR 0.60; 0.39, 0.92; n=2); Mercaptopurine (RR 0.77, 0.55, 1.08; n=2) were studied by two or more studies (figure 1). The overall effect was not significant (RR 0.64, 0.27, 1.52).Download figure Open in new tab Download powerpoint Abstract P70 Figure 1 Conclusion Few studies compared medication or nutrition or supplements to prevent postoperative recurrence in patients with Crohn's disease. Infliximab and/or thiopurines may offer a therapeutic option in reducing postoperative endoscopic recurrence of Crohn's disease, however the impact of newer biologics and small molecules requires evaluation."

Retrospective data • Review • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease

Comparative efficacy and safety of therapies for adult ulcerative colitis: a network meta-analysis (IDDF 2025) - "Tacrolimus showed the highest clinical response rate (RR 0.25, 95% CI 0.06–0.57; SUCRA, 93.7%) and mucosal healing and mercaptopurine (6-MP) had the highest rank for clinical remission (RR=0.63, 95%CI 0.55–0.86; SUCRA, 85.8%) but the lowest for AEs (RR=1.25, 95%CI 1.20–1.80; SUCRA, 14.2%) for mild to moderate UC...Infliximab uniquely increased the risk of serious AEs (RR=1.70, 95%CI 1.52–1.96)...The study's conclusions should be cautiously interpreted due to potential biases and heterogeneity.Conclusions Tacrolimus was the optimal therapy for mild-to-moderate UC patients, and for moderate-to-severe UC was Vedolizumab through a network meta-analysis that considered both efficacy and safety. However, further comparative studies are needed to enhance clinical decision-making confidence."

Retrospective data • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Green Synchronous Spectrofluorimetric Analysis of Methotrxate, With 6-Mercaptopurine as Add-On Therapy of Childhood Acute Lymphoblastic Leukemia: Application in Laboratory Prepared Mixtures, Spiked Human Plasma, and Dosage Forms. (PubMed, Luminescence) - "It was the first time that a spectrofluorimetric approach for the simultaneous analysis of methotrexate (MET) and 6-mercaptopurine (6-MP) had been achieved. The validation of the procedure was successfully completed in compliance with ICH guidelines. To assess the analytical methodology's greenness, Eco-Scale and GAPI greenness tools were employed."

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

Thiopurines and intrahepatic cholestasis of pregnancy in systemic lupus erythematosus and inflammatory bowel disease pregnancies. (PubMed, Am J Gastroenterol) - "In SLE and IBD, thiopurine exposure during pregnancy was associated with an increased risk of ICP, regardless of ICP history, hypertension, renal diseases, liver diseases, and glucocorticoid use."

Journal • Cardiovascular • Cholestasis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertension • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Nephrology • Oncology • Renal Disease • Systemic Lupus Erythematosus

Clinical utility of thiopurine metabolite levels in monitoring patients with inflammatory bowel disease: A single-centre retrospective study. (PubMed, Indian J Gastroenterol) - "Only one-third of patients on thiopurine therapy reached therapeutic levels and 6-TGN levels did not correlate with remission. Most patients had sub-therapeutic 6-TGN levels, resulting in poor disease control despite on recommended doses. Literature-defined 6-TGN targets may be insufficient for Indian IBD patients. Larger studies are needed to determine the optimal 6-TGN target and therapeutic threshold for remission in our population."

Journal • Retrospective data • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • NUDT15

DNA-incorporated thioguanine to detect potential non-adherence to maintenance therapy in acute lymphoblastic leukemia. (PubMed, Cancer Chemother Pharmacol) - "DNA-TG can provide a cost-effective guidance on when to measure TGN and MeMP to determine whether non-adherence should be suspected, which is an additional benefit to monitoring DNA-TG during maintenance therapy."

Journal • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • TPMT

The NUDIX hydrolase NUDT5 influences purine nucleotide metabolism and thiopurine pharmacology. (PubMed, J Clin Invest) - "Thiopurines (TPs), including 6-mercaptopurine and 6-thioguanine, are cornerstone agents for the treatment of acute lymphoblastic leukemia (ALL). Clinically, NUDT5 expression variants were associated with altered TP tolerance. These findings position NUDT5 as a key modulator of nucleotide metabolism and TP efficacy, with potential implications for pharmacogenomics-guided therapy optimization in ALL."

Journal • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • NUDT15 • NUDT5 • TPMT

A Study of Different Programs to Help ALL Patients With Taking Maintenance Medicine at Home (clinicaltrials.gov) - P=N/A | N=64 | Active, not recruiting | Sponsor: Children's Oncology Group | Recruiting ➔ Active, not recruiting

Enrollment closed • Acute Lymphocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Results of a Randomized Augmented Intensification Phase in Acute Lymphoblastic Leukemia in Children in Argentina: GATLA 2010 ALL IC Trial. (PubMed, Pediatr Blood Cancer) - "Among newly diagnosed pediatric patients with IR and HR ALL treated in Argentina, postinduction intensification with augmented IB did not improve outcomes compared with standard IB. Standard IB should be used for these patients. Future trials should focus on reducing TRM."

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

Pharmacogenomics in leukemia treatment (PubMed, Rinsho Ketsueki) - "In particular, the NUDT15 polymorphism, which determines sensitivity to 6-mercaptopurine, has garnered significant attention...Studies have also explored the relationship between genetic background and late complications of leukemia treatment. Optimization of therapeutic strategies based on pharmacogenetic insights holds promise for minimizing complications while maximizing treatment efficacy for each individual patient."

Biomarker • Journal • Review • Hematological Malignancies • Leukemia • Oncology • NUDT15

Azathioprine as a substitute for 6-mercaptopurine in childhood acute lymphoblastic leukemia: a single-center retrospective study. (PubMed, Leuk Lymphoma) - "Taken together, AZA may serve as an effective alternative to 6-MP for the treatment of childhood ALL. However, enhanced monitoring of treatment-related toxicities is recommended during AZA-based therapy."

Journal • Retrospective data • Acute Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Leukopenia • Neutropenia • Oncology

HUVAMER: A Study to Investigate Treatment of HU and VPA, or 6-MP and VPA in Unfit AML/HR-MDS Patients (clinicaltrials.gov) - P1/2 | N=48 | Recruiting | Sponsor: Haukeland University Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Myelodysplastic Syndrome • Oncology

Nutritional status, body composition and chemotherapy dosing in children and young people with cancer: a systematic review by the SIOP nutrition network. (PubMed, Br J Cancer) - "Relevant pharmacokinetic parameters were described for mercaptopurine, vincristine, anthracyclines, methotrexate, busulfan, bevacizumab, and crizotinib. Prospective studies should incorporate uniform definitions and standardised pharmacological approaches to optimise treatment options for children with cancer globally. SYSTEMATIC LITERATURE REVIEW REGISTRATION: PROSPERO: (reference: CRD42023435261)."

Journal • Review • Genetic Disorders • Obesity • Oncology

Using pharmacogenomics to personalise drug therapy: which drugs, when and how. (PubMed, Aust Prescr) - "At the time of writing, tests for thiopurine methyltransferase (TPMT) (azathioprine, mercaptopurine, thioguanine) and human leucocyte antigen B*57:01 (abacavir) are Medicare-rebated. Pharmacogenomic testing is also recommended for several other drugs, such as allopurinol and clopidogrel, but these do not currently attract a Medicare rebate."

Biomarker • Journal • Review

Bone Marrow Aplasia and Neutropenic Fever Following Azathioprine Dose Escalation in a TPMT-Deficient Patient with Crohn's Disease and Psoriatic Arthritis-A CARE-Compliant Case. (PubMed, Clin Pract) - "Additionally, the concomitant use of xanthine oxidase inhibitors and 5-aminosalicylates may slow the metabolism of 6-mercaptopurine...Discontinuation of AZA, multiple transfusions of red blood cells and platelet concentrate, filgrastim, empirical antibiotic therapy, and antiviral and antifungal prophylaxis were obtained after 11 days complete recovery of bone marrow aplasia... This case highlights the importance of monitoring the total blood count frequently during the first weeks of treatment with moderate-to-high doses of AZA. Furthermore, the interaction between AZA and mesalazine may play a significant role in the development of prolonged bone marrow aplasia."

Journal • Aplastic Anemia • Crohn's disease • Febrile Neutropenia • Gastroenterology • Hematological Disorders • Immunology • Inflammatory Arthritis • Inflammatory Bowel Disease • Leukopenia • Neutropenia • Psoriatic Arthritis • Rheumatology • Seronegative Spondyloarthropathies • NUDT15

Multiple aseptic abscesses and pulmonary involvement in a child with Behcet's disease phenotype: a case report. (PubMed, Front Immunol) - "Through a regimen involving steroids, mercaptopurine, thalidomide endoscopic drainage of the gastric wall abscess, the child's condition has been effectively managed and improved. To our knowledge, this is the first reported case of BD phenotype with a gastric wall abscess treated with endoscopic drainage and steroids. Multiple AAs and interstitial lung disease may be the early signs of a BD phenotype in childhood which can respond effectively to glucocorticoids."

Journal • Gastrointestinal Disorder • Hematological Disorders • Immunology • Interstitial Lung Disease • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Vascular Neurology • Vasculitis

THE EFFICACY AND SAFETY OF LUVOMETINIB (FCN-159) IN PEDIATRIC PATIENTS WITH REFRACTORY/RELAPSED LANGERHANS CELL HISTIOCYTOSIS: A MULTI-CENTER, OPEN-LABEL, SINGLE-ARM PHASE II STUDY (EHA 2025) - P2 | "Current first-line treatment recommended by Histiocyte Society for children with multifocal disease is vinblastine and prednisone. For patients with risk-organ involvement, additional 6-mercaptopurine is also used as maintenance therapy...While cobimetinib has been approved for the treatment of adult patients, it has not yet been approved for pediatric patients... The preliminary study results showed that luvometinib was highly efficacious for pediatric patients with refractory/relapsed LCH. In addition, luvometinib was well tolerated, without TRAEs-induced discontinuation reported. Trial Information: NCT05997602, CTR20232238."

Clinical • P2 data • Anemia • Dermatitis • Dermatology • Genetic Disorders • Hematological Disorders • Immunology • Infectious Disease • Langerhans Cell Histiocytosis • Neurofibromatosis • Pediatrics • Rare Diseases • Solid Tumor • ARAF • BRAF • CD1a

ACUTE TOXICITIES DURING INDUCTION AND FIRST CONSOLIDATION TREATMENT OF YOUNG ADULTS WITH ALL: COMPARISON OF ALL CELL 2023 JUNIOR AND GMALL 07/2003 PROTOCOLS - A SINGLE CENTER EXPERIENCE (EHA 2025) - "The ALL CELL 2023 Junior Induction protocol, incorporating two doses of pegasparaginase alongside reduced cytarabine, cyclophosphamide, and delayed start of 6-mercaptopurine, did not increase the risk of acute toxicities, including asparaginase-associated pancreatitis or thromboembolism, compared to GMALL. Furthermore, severe toxicities were less frequent in CELL. The introduction of pegasparaginase activity monitoring and complex genomic profiling has enabled a more personalized approach, including TDM-based dose adjustments."

Clinical • Acute Lymphocytic Leukemia • Cardiovascular • Dyslipidemia • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hepatology • Hypertriglyceridemia • Infectious Disease • Leukemia • Mucositis • Neutropenia • Oncology • Otorhinolaryngology • Pancreatitis

Organic-Inorganic Magnetic Nanoparticles Based on Magnetite Coated with Molecularly Imprinted Polymers for Drug Delivery Systems. (PubMed, ACS Omega) - "The resultant nanocomposites were tested as Drug Delivery Systems (DDS) of 6-mercaptopurine (6-MP), displaying an interesting behavior depending on (a) the synthesis method used for their preparation and (b) the conditions employed for the release test. DDS based on methacrylic acid displayed the best performance in the release of 6-MP in all cases, but the rationalization of a magnetite MIP (molecularly imprinted polymer) system of this monomer enhanced the release yield by approximately 50% compared with the nonimprinted system (NIP) prepared with the same monomer. New MNP obtained are able to behave as DDS under magnetic hyperthermia with a moderate performance in contrast to the release in the absence of magnetic field."

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Drug-induced liver injury in pediatric age group: Single-center experience. (PubMed, Pediatr Int) - "Hepatocellular type was found to be the most common type among the patterns of liver injury in the pediatric age group. Although antibiotics constitute the leading cause of DILI, antibiotic choices are changing due to increasing resistant infections. The frequency of carbapenem-induced DILI is increasing."

Journal • Hepatology • Infectious Disease • Inflammation • Liver Failure • Pediatrics

Human xenobiotic metabolism proteins have full-length and split homologs in the gut microbiome. (PubMed, G3 (Bethesda)) - "We identify twelve specific drugs that gut microbial split homologs may metabolize; two of these, 6-mercaptopurine by xanthine dehydrogenase (XDH) and 5-fluorouracil by dihydropyrimidine dehydrogenase (DPYD), have been recently confirmed in mouse models. This work provides a comprehensive map of homology between the human and gut microbial proteomes, indicates which human xenobiotic enzyme classes are most likely to be shared by gut microorganisms, and finally demonstrates that split homology may be an underappreciated explanation for microbial contributions to drug metabolism."

Journal • DPYD

Upconversion luminescence nanosensor based on the inner filter effect for rapid detection of the anticancer drug 6-mercaptopurine. (PubMed, Mikrochim Acta) - "The resulting detection range and the limit of detection (LOD) were 0-15 μg·mL-1 and 0.56 μg·mL-1, respectively. The "off-on" UCL nanosensor designed for the detection of 6-MP exhibits the advantages of easy operation, rapid response time, and high sensitivity, demonstrating promising potential for application in clinical monitoring."

Journal • Oncology

A new insight of structures, bonding and electronic properties for 6-mercaptopurine adsorbed on M@Au12 (M=Au, Ag, Pd and Pt) Nanoclusters: a theoretical perspective. (PubMed, J Mol Graph Model) - "The adsorption energy Ead including BSSE for Pt@Au12-6MP-7 is the lowest with -1.41eV in the gas phase and that for Pd@Au12-6MP-7 is the lowest with -1.12 eV in the aqueous phase. The electronic property, molecular orbital analysis, density of states, the second order perturbation energy in NBO explicit that Pt@Au12-6MP-7 and Pd@Au12-6MP-7 are better potential candidate for 6 MP drug delivery."

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