“…The interpatient susceptibility to high‐dose ara‐C regimens is linked to the propensity of AML blasts to accumulate the active triphosphate metabolite ara‐CTP (Plunkett et al , ), which causes DNA damage by perturbing DNA synthesis (Tsesmetzis et al , ). A main determinant for ara‐CTP exposure, and thus a key factor for ara‐C efficacy, is the deoxynucleoside triphosphate (dNTP) triphosphohydrolase SAM and HD domain‐containing protein‐1 (SAMHD1), which we and others identified as an ara‐CTPase (Schneider et al , ; Herold et al , ,b,c; Hollenbaugh et al , ; Rudd et al , ; Rassidakis et al , ). Accordingly, inactivation of SAMHD1 is a prime goal for rational improvement of ara‐C‐based therapies; however, no valid clinical strategies exist, nor are known efforts under development ().…”