| NUDT15 germline variants (e.g., a missense SNP:rs116855232, inducing R139C) have been linked to clinical usage of thiopurines (e.g., mercaptopurine) in [[acute lymphoblastic leukemia]]<ref>{{cite journal | vauthors = Moriyama T, Nishii R, Perez-Andreu V, Yang W, Klussmann FA, Zhao X, Lin TN, Hoshitsuki K, Nersting J, Kihira K, Hofmann U, Komada Y, Kato M, McCorkle R, Li L, Koh K, Najera CR, Kham SK, Isobe T, Chen Z, Chiew EK, Bhojwani D, Jeffries C, Lu Y, Schwab M, Inaba H, Pui CH, Relling MV, Manabe A, Hori H, Schmiegelow K, Yeoh AE, Evans WE, Yang JJ | display-authors = 6 | title = NUDT15 polymorphisms alter thiopurine metabolism and hematopoietic toxicity | journal = Nature Genetics | volume = 48 | issue = 4 | pages = 367–73 | date = April 2016 | pmid = 26878724 | doi = 10.1038/ng.3508 }}</ref><ref>{{cite journal | vauthors = Yang JJ, Landier W, Yang W, Liu C, Hageman L, Cheng C, Pei D, Chen Y, Crews KR, Kornegay N, Wong FL, Evans WE, Pui CH, Bhatia S, Relling MV | display-authors = 6 | title = Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia | journal = Journal of Clinical Oncology | volume = 33 | issue = 11 | pages = 1235–42 | date = April 2015 | pmid = 25624441 | doi = 10.1200/JCO.2014.59.4671 }}</ref> as well as inflammatory bowel diseases to avoid thiopurine-induced leukopenia.<ref>{{cite journal | vauthors = Yang SK, Hong M, Baek J, Choi H, Zhao W, Jung Y, Haritunians T, Ye BD, Kim KJ, Park SH, Park SK, Yang DH, Dubinsky M, Lee I, McGovern DP, Liu J, Song K | display-authors = 6 | title = A common missense variant in NUDT15 confers susceptibility to thiopurine-induced leukopenia | journal = Nature Genetics | volume = 46 | issue = 9 | pages = 1017–20 | date = September 2014 | pmid = 25108385 | doi = 10.1038/ng.3060 }}</ref><ref>{{cite journal | vauthors = Yin D, Xia X, Zhang J, Zhang S, Liao F, Zhang G, Zhang Y, Hou Q, Yang X, Wang H, Ma Z, Wang H, Zhu Y, Zhang W, Wang Y, Liu B, Wang L, Xu H, Shu Y | display-authors = 6 | title = Impact of NUDT15 polymorphisms on thiopurines-induced myelotoxicity and thiopurines tolerance dose | journal = Oncotarget | volume = 8 | issue = 8 | pages = 13575–13585 | date = February 2017 | pmid = 28088792 | doi = 10.18632/oncotarget.14594 }}</ref> These variants also exhibit ethnicity-specific (e.g.,variant allele of rs116855232 is high is East Asians and Hispanics but low in Caucasians and Africans). Rare functional variants even singletons in this gene have also been identified to be related to thiopurine-induced myelotoxicity,<ref>{{cite journal|last1=Moriyama|first1=T|last2=Yang|first2=YL|last3=Nishii|first3=R|last4=Ariffin|first4=H|last5=Liu|first5=C|last6=Lin|first6=TN|last7=Yang|first7=W|last8=Lin|first8=DT|last9=Yu|first9=CH|last10=Kham|first10=S|last11=Pui|first11=CH|last12=Evans|first12=WE|last13=Jeha|first13=S|last14=Relling|first14=MV|last15=Yeoh|first15=AE|last16=Yang|first16=JJ|title=Novel variants in ''NUDT15'' and thiopurine intolerance in children with acute lymphoblastic leukemia from diverse ancestry.|journal=Blood|date=28 June 2017|doi=10.1182/blood-2017-05-782383|pmid=28659275}}</ref> suggesting the whole gene screening should be taken to determine the initial dosage using of thiopurine. | | NUDT15 germline variants (e.g., a missense SNP:rs116855232, inducing R139C) have been linked to clinical usage of thiopurines (e.g., mercaptopurine) in [[acute lymphoblastic leukemia]]<ref>{{cite journal | vauthors = Moriyama T, Nishii R, Perez-Andreu V, Yang W, Klussmann FA, Zhao X, Lin TN, Hoshitsuki K, Nersting J, Kihira K, Hofmann U, Komada Y, Kato M, McCorkle R, Li L, Koh K, Najera CR, Kham SK, Isobe T, Chen Z, Chiew EK, Bhojwani D, Jeffries C, Lu Y, Schwab M, Inaba H, Pui CH, Relling MV, Manabe A, Hori H, Schmiegelow K, Yeoh AE, Evans WE, Yang JJ | display-authors = 6 | title = NUDT15 polymorphisms alter thiopurine metabolism and hematopoietic toxicity | journal = Nature Genetics | volume = 48 | issue = 4 | pages = 367–73 | date = April 2016 | pmid = 26878724 | doi = 10.1038/ng.3508 | pmc=5029084}}</ref><ref>{{cite journal | vauthors = Yang JJ, Landier W, Yang W, Liu C, Hageman L, Cheng C, Pei D, Chen Y, Crews KR, Kornegay N, Wong FL, Evans WE, Pui CH, Bhatia S, Relling MV | display-authors = 6 | title = Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia | journal = Journal of Clinical Oncology | volume = 33 | issue = 11 | pages = 1235–42 | date = April 2015 | pmid = 25624441 | doi = 10.1200/JCO.2014.59.4671 | pmc=4375304}}</ref> as well as inflammatory bowel diseases to avoid thiopurine-induced leukopenia.<ref>{{cite journal | vauthors = Yang SK, Hong M, Baek J, Choi H, Zhao W, Jung Y, Haritunians T, Ye BD, Kim KJ, Park SH, Park SK, Yang DH, Dubinsky M, Lee I, McGovern DP, Liu J, Song K | display-authors = 6 | title = A common missense variant in NUDT15 confers susceptibility to thiopurine-induced leukopenia | journal = Nature Genetics | volume = 46 | issue = 9 | pages = 1017–20 | date = September 2014 | pmid = 25108385 | doi = 10.1038/ng.3060 | pmc=4999337}}</ref><ref>{{cite journal | vauthors = Yin D, Xia X, Zhang J, Zhang S, Liao F, Zhang G, Zhang Y, Hou Q, Yang X, Wang H, Ma Z, Wang H, Zhu Y, Zhang W, Wang Y, Liu B, Wang L, Xu H, Shu Y | display-authors = 6 | title = Impact of NUDT15 polymorphisms on thiopurines-induced myelotoxicity and thiopurines tolerance dose | journal = Oncotarget | volume = 8 | issue = 8 | pages = 13575–13585 | date = February 2017 | pmid = 28088792 | doi = 10.18632/oncotarget.14594 | pmc=5355121}}</ref> These variants also exhibit ethnicity-specific (e.g.,variant allele of rs116855232 is high is East Asians and Hispanics but low in Caucasians and Africans). Rare functional variants even singletons in this gene have also been identified to be related to thiopurine-induced myelotoxicity,<ref>{{cite journal|last1=Moriyama|first1=T|last2=Yang|first2=YL|last3=Nishii|first3=R|last4=Ariffin|first4=H|last5=Liu|first5=C|last6=Lin|first6=TN|last7=Yang|first7=W|last8=Lin|first8=DT|last9=Yu|first9=CH|last10=Kham|first10=S|last11=Pui|first11=CH|last12=Evans|first12=WE|last13=Jeha|first13=S|last14=Relling|first14=MV|last15=Yeoh|first15=AE|last16=Yang|first16=JJ|title=Novel variants in ''NUDT15'' and thiopurine intolerance in children with acute lymphoblastic leukemia from diverse ancestry.|journal=Blood|date=28 June 2017|doi=10.1182/blood-2017-05-782383|pmid=28659275|volume=130|pmc=5606007|pages=1209–1212}}</ref> suggesting the whole gene screening should be taken to determine the initial dosage using of thiopurine. |