TPMT/NUDT15 Thiopurine Dosing Simulator

Thiopurine drugs like azathioprine and 6-mercaptopurine treat leukemia, Crohn's disease and transplant rejection — but in patients with reduced TPMT or NUDT15 enzyme activity, a standard dose can trigger life-threatening bone-marrow suppression. This simulator lets you pick a patient's TPMT and NUDT15 metabolizer phenotype, choose between fixed-dose and genotype-guided dosing strategies, and start a simulated 28-day course of therapy. A real pharmacokinetic/pharmacodynamic model accumulates the active 6-TGN metabolite and drives a live neutrophil count (ANC) toward safety or severe neutropenia, rendered as a shrinking field of marrow cells in 3D — demonstrating exactly why pre-emptive pharmacogenomic testing is now standard of care before thiopurine therapy begins.