Joseph Torkildson
- Clinical Professor, Pediatrics
Contact
- (520) 626-7053
- AHSC, Rm. 3301
- jtorkildson@arizona.edu
Degrees
- M.B.A. Business Administration
- University of Texas at San Antonio, San Antonio, Texas
- M.D.
- Medical College of Wisconsin, Wauwatosa, Wisconsin
Interests
No activities entered.
Courses
No activities entered.
Scholarly Contributions
Books
- Torkildson, J. (2021). Handbook of Pediatric Hematology/Oncology. Wiley.More infoHandbook of Pediatric Hematology and Oncology: Children's Hospital & Research Center Oakland, Third EditionAuthor(s):Dr. Caroline A. Hastings, Dr. Joseph C. Torkildson, Dr. Anurag K. AgrawalFirst published:5 February 2021Print ISBN:9781119210740 |Online ISBN:9781119210771 |DOI:10.1002/9781119210771© 2021 John Wiley & Sons Ltd.
Journals/Publications
- Torkildson, J., Raphael, R., Mosher, N., Michlitsch, J., Golden, C., Feusner, J. H., Beach, B., & Agrawal, A. K. (2022). Utilization of Thiopurine Metabolites and Allopurinol in Pediatric Acute Lymphoblastic Leukemia: Consideration for an Algorithmic Approach.. Journal of pediatric hematology/oncology, 44(2), e521-e525. doi:10.1097/mph.0000000000002313More infoPersistently elevated absolute neutrophil counts during maintenance for acute lymphoblastic leukemia is a risk factor for relapse and may be related to wild-type thiopurine methyltransferase activity and overly efficient shunting of 6-mercaptopurine to hepatotoxic metabolites (6-methylmercaptopurine nucleotides), leading to low 6-thioguanine nucleotides. 6-mercaptopurine is also metabolized by xanthine oxidase, and therefore allopurinol, an inhibitor of xanthine oxidase, allows for increased 6-thioguanine nucleotides and decreased 6-methylmercaptopurine nucleotide. Here, we report our experience with allopurinol for persistently elevated absolute neutrophil count or hepatotoxicity and suggest an algorithmic approach for checking thiopurine metabolites and initiating allopurinol in acute lymphoblastic leukemia maintenance.
