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Lenaldekar is a novel small molecule discovered through a high-content in vivo zebrafish screen designed to identify targeted anti-leukemia agents. It functions by inhibiting T-cell expansion in a non-cytolytic manner, primarily by modulating the insulin-like growth factor-1 receptor (IGF-1R) pathway. This modulation leads to a marked reduction in T-cell proliferation and expansion. Additionally, Lenaldekar causes dephosphorylation of members of the PI3 kinase/AKT/mTOR pathway and delays sensitive cells in late mitosis. It has shown therapeutic efficacy in preclinical models of multiple sclerosis (experimental autoimmune encephalomyelitis) by suppressing relapses and preserving white matter integrity, and has demonstrated selective toxicity against various leukemias, including T-cell acute lymphoblastic leukemia, B-ALL, and chronic myelogenous leukemia.
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