Evidence map›Paper›PMID 41014199›Full record

ArticleBritish journal of haematology2025

Addition of hydroxyurea (hydroxycarbamide) enhances the efficacy of fludarabine/cytarabine-based salvage regimens against acute myeloid leukaemia.

Ingrid Lilienthal, Sijia Tao, Christer Nilsson, Elory Leonard, Runqing Zhang, Agnes L Sorteberg, Louisa Fredrikson, Ioanna Xagoraris, Shahrzad Shirazi Fard, Nikolaos Tsesmetzis and 14 more

Abstract read
In one paragraph

Article in British journal of haematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Ingrid LilienthalDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-5270-7268
Sijia TaoLaboratory of Biochemical Pharmacology, Department of Pediatrics, Center for ViroScience and Cure, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Christer NilssonDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0003-0695-0050
Elory LeonardDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Runqing ZhangDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0009-0001-0746-5594
Agnes L SortebergDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Louisa FredriksonDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Ioanna XagorarisDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Shahrzad Shirazi FardDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Nikolaos TsesmetzisDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Vasilios ZachariadisDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Huan CaiDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Lakshmi SandhowDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Anette LangebäckDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Anna BohlinDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Katja Pokrovskaja TammDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Sofia BengtzénDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Raymond F SchinaziLaboratory of Biochemical Pharmacology, Department of Pediatrics, Center for ViroScience and Cure, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Sören LehmannDepartment of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Baek KimLaboratory of Biochemical Pharmacology, Department of Pediatrics, Center for ViroScience and Cure, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Georgios Z RassidakisDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Hong QianDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Martin JäderstenDepartment of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Nikolas HeroldDivision of Pediatric Oncology and Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-9468-4543

Funding

Lentivirus Replication Strategy and PathogenesisR01AI136581 · NIAID · EMORY UNIVERSITY · PI Baek Kim · 2018 to 2026
$3.9M
Towards Suppression and Elimination of HIV in the CNSR01MH116695 · NIMH · EMORY UNIVERSITY · PI SCHINAZI, RAYMOND FELIX, TYOR, WILLIAM R · 2018 to 2022
$3.4M
SAMHD1 mediated dNTP regulation and HIV in myeloid cellsR01AI162633 · NIAID · EMORY UNIVERSITY · PI Baek Kim · 2021 to 2026
$2.7M
Barncancerfonden PR2020-0077Barncancerfonden PR2020-0166Cancerfonden 1222PjFCancerfonden 1494 PjCancerfonden 19 0092Cathrine Everts FoundationNIAID NIH HHS R01 AI136581NIAID NIH HHS R01 AI162633NIH HHS AI136581NIH HHS AI162633NIH HHS MH116695NIMH NIH HHS R01 MH116695Nordic Cancer Union R279-A15951Radiumhemmets Forskningsfonder 191253Region Stockholm FoUI-974942Sjöbergstiftelsen 2020-008Svenska läkarsällskapet SLS-961737Vetenskapsrådet 2020-01184Vetenskapsrådet 2022-01228Wellcome Trust 211143
6 · The paper itself

Abstract

Despite intensive treatment, patients with relapsed or refractory acute myeloid leukaemia (AML) have a dismal prognosis. A cornerstone therapy for relapsed/refractory AML is a combination of fludarabine (F-ara-A) and cytarabine (ara-C), so-called FLA. As the enzyme SAMHD1 mediates resistance to both ara-C and F-ara-A, we investigated whether SAMHD1 inhibition via hydroxyurea (hydroxycarbamide; HU) could improve FLA efficacy. Here, we show that HU synergistically enhanced ara-C-, F-ara-A- and FLA-induced cytotoxicity in an SAMHD1-dependent manner in AML cell lines, primary AML cells and an immunocompetent AML mouse model. Mechanistically, HU significantly increased the active metabolite triphosphates of ara-C and F-ara-A in FLA combinations. Furthermore, leukaemic SAMHD1 protein expression negatively correlated with overall survival in a cohort of FLA-treated refractory AML patients. Our findings suggest that the addition of HU improves the efficacy of FLA-based regimens and warrant clinical trials to test the safety and efficacy of this combination in patients with relapsed/refractory AML.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsHydroxyureaLeukemia, Myeloid, AcuteSalvage TherapyAnimalsCell Line, TumorCytarabineDrug SynergismFemaleHumansMaleMiceMiddle AgedSAM Domain and HD Domain-Containing Protein 1VidarabineCytarabinefludarabineHydroxyureaSAM Domain and HD Domain-Containing Protein 1SAMHD1 protein, humanVidarabineAMLrelapse/refractorySAMHD1

Identifiers

PMID41014199
PMCPMC12710166

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.