Evidence map›Paper›PMID 42286409›Full record

ArticleClinical and translational science2026

Severe Thiopurine-Induced Myelosuppression in a Pediatric Acute Lymphoblastic Leukemia Patient With the NUDT15 *1/*6 Genotype: A Brief Report.

Jillian Fry, Erin C Boone, Wendy Y Wang, Shobana John, Lisa A Lansdon, Midhat S Farooqi, Byunggil Yoo, Andrea Gaedigk, Keith August, Terrie G Flatt and 1 more

Erratum issuedAbstract readCase Reports
In one paragraph

Article in Clinical and translational science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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

5 · Who and what money

Authors and funding

11 authors.

Jillian FryDivision of Hematology/Oncology/BMT, Children's Mercy Kansas City, Kansas City, USA.
Erin C BooneDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute, Kansas City, USA.ORCID 0000-0003-3044-5521
Wendy Y WangDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute, Kansas City, USA.ORCID 0000-0002-0203-0196
Shobana JohnDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute, Kansas City, USA.ORCID 0000-0002-7953-4616
Lisa A LansdonDepartment of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, USA.
Midhat S FarooqiDepartment of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, USA.
Byunggil YooDepartment of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, USA.
Andrea GaedigkDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute, Kansas City, USA.ORCID 0000-0001-6968-1893
Keith AugustDivision of Hematology/Oncology/BMT, Children's Mercy Kansas City, Kansas City, USA.
Terrie G FlattDivision of Hematology/Oncology/BMT, Children's Mercy Kansas City, Kansas City, USA.
Laura B RamseyDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute, Kansas City, USA.ORCID 0000-0001-6417-3961

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Variants in TPMT and NUDT15 genes that affect thiopurine metabolism can guide personalized dosing to minimize toxicity. Decreased or no appreciable NUDT15 activity demonstrates impaired breakdown of active thiopurine metabolites which can lead to severe adverse events including potentially life-threatening myelosuppression. Recently, the NUDT15*6 allele was re-classified from having uncertain function to no function by the Clinical Pharmacogenetics Implementation Consortium. Here, we present a pediatric patient with a NUDT15*1/*6 genotype who experienced significant thiopurine-induced myelosuppression. The patient is a 4-year-old female with standard risk-average precursor B-cell acute lymphoblastic leukemia treated per AALL1731. Exome sequencing determined TPMT*1/*1 (normal metabolizer) and NUDT15*1/*6 (indeterminate metabolizer). After 75 mg/m

Indexed as

Antimetabolites, AntineoplasticMercaptopurinePrecursor B-Cell Lymphoblastic Leukemia-LymphomaPrecursor Cell Lymphoblastic Leukemia-LymphomaPyrophosphatasesChild, PreschoolFemaleGenotypeHumansMethyltransferasesNudix HydrolasesAntimetabolites, AntineoplasticMercaptopurineMethyltransferasesNudix HydrolasesNUDT15 protein, humanPyrophosphatasesTPMT protein, humanchemotherapyoncologypediatricpharmacogenomicstoxicity

Identifiers

PMID42286409
PMCPMC13263158

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Registered trials

None linked

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.