One of the most-used AML drugs is cytarabine (ara-C), which interferes with DNA replication. But, many patients do not response to ara-C because their leukemia cells express high levels of the enzyme SAMHD1. SAMHD1 breaks down ara-CTP, the active metabolite of cytarabine. As a result, these patients have much worse survival rates than ones with low levels of SAMHD1.
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