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Portrait of Gertrude B. Elion
Photo: GlaxoSmithKline plc, GSK Heritage Archives · CC BY 4.0 via Wikimedia Commons

Nobel Prize in Physiology or Medicine · 1988

Gertrude B. Elion

She designed drugs that help cure childhood leukemia and made organ transplants workable, and helped create the first selective herpes drug.

The Nobel citation: “for their discoveries of important principles for drug treatment”
Born
January 23, 1918, New York, NY, USA
Died
February 21, 1999, Chapel Hill, NC, USA
Shared with
Sir James W. Black, George H. Hitchings
Affiliation at the time
Wellcome Research Laboratories, USA

Medicine prize

1988

Shared with 2 other laureates.

Age that year

70years

Born in 1918.

Headline credited impact

48,000–65,600lives saved

Children and teens cured of acute lymphoblastic leukemia by modern combination chemotherapy. How it was built

Sources cited

24

Fact-checked September 24, 2026.

  • She never earned a PhD: after two years of night classes she was told to quit her job or quit school, and she kept the job.
  • Her leukemia drug 6-MP won US approval in 1953, about two years after she first made it. It is still a mainstay of care that cures over 90% of children with ALL in rich countries.
  • Her drug azathioprine, paired with prednisone, made kidney transplants from unrelated donors workable in the early 1960s and anchored anti-rejection treatment until about 1980.
  • In 1991 she became the first woman inducted into the US National Inventors Hall of Fame. She held 45 patents.
  • Turned away from paid lab jobs as a woman, she worked unpaid for a chemist and endured daily antisemitic jokes from the company's president.

The breakthrough

Designing drugs from look-alike DNA building blocks (1948-1977)

In the 1940s most new medicines were found by trial and error: chemists tweaked natural substances and hoped something worked. George Hitchings wanted to design drugs from an understanding of how cells work, and Elion became his partner in doing it. Every cell needs DNA to divide, and DNA is built from small parts, including ones called purines. Cancer cells, bacteria and parasites divide fast, so they need a lot of these parts. The idea was to make slightly altered copies of purines that a fast-growing cell would grab and then choke on. Elion's team called such a molecule a rubber doughnut: a convincing fake that the cell cannot use. Her job was the purines. Years before anyone knew DNA's double-helix shape, she made and tested more than 100 of them, using a bacterium as a quick test. In 1950 and 1951, by swapping one oxygen atom for a sulfur atom, she produced thioguanine and 6-mercaptopurine (6-MP). In children with leukemia, 6-MP brought remissions. Studying how the body handled 6-MP led her to azathioprine, which calms the immune system, and allopurinol, which cuts the body's production of uric acid. In the 1970s her group worked out why acyclovir hits herpes so precisely: only an enzyme made by the virus itself can take the first step in switching the drug on, so healthy cells are largely spared.[3],[4],[6],[7],[8]

“What we were aiming at was getting people well, and the satisfaction of that is much greater than any prize you can get.”
Gertrude B. Elion, Speaking about the Nobel Prize in a 1997 interview with Mary Ellen Avery, quoted in her National Academy of Sciences biographical memoir.[6]

What it meant for humanity

Several of Elion's medicines turned death sentences into treatable conditions. Before 6-MP, children with acute leukemia usually lived three to four months after diagnosis. Her drug won US approval in 1953, a little over two years after it was first made, and it became a mainstay of the long maintenance phase of treatment. Combined with other drugs, it now helps cure more than 90% of children with acute lymphoblastic leukemia (ALL) in rich countries, up from about 14% surviving five years in the 1960s. Worldwide, deaths from ALL in people under 20 fell by half between 1990 and 2021, though survival in poorer countries still lags. Azathioprine made transplants between unrelated people workable: in 1962 a Boston patient given it kept a kidney from an unrelated donor for well over a year, and paired with prednisone it anchored transplant medicine until cyclosporine arrived around 1980. Surgeons now perform more than 170,000 organ transplants a year worldwide. Allopurinol prevents the painful uric acid crystals of gout and uric acid kidney stones, and it protects cancer patients from uric acid surges during chemotherapy. Acyclovir was the first antiviral drug to attack herpes viruses while largely sparing healthy cells. It eases genital herpes and shingles, protects leukemia and bone marrow transplant patients from herpes flare-ups, and cut deaths from herpes encephalitis, a brain infection, from about 70% untreated to roughly 10-20%. The method mattered too. By showing that drugs could be designed around the differences between healthy and harmful cells, Elion and Hitchings changed how medicines are discovered. Colleagues at her company used the same approach to develop AZT, for years the only licensed AIDS drug in the United States. Elion also mentored young scientists and used a $250,000 gift from her company to fund Hunter College scholarships for women graduate students in chemistry.

  • Before 6-MP, children with acute leukemia typically lived three to four months. Modern combination chemotherapy, with 6-MP as a mainstay, cures more than 90% of children with ALL in high-income countries.[3],[9],[10],[11]
  • Paired with prednisone, azathioprine made kidney transplants from unrelated donors workable from 1962-63 and remained the backbone of anti-rejection treatment until cyclosporine arrived around 1980.[3],[4],[13]
  • Acyclovir (1977) was the first antiviral drug to attack herpes viruses while largely sparing healthy cells. In a 1986 trial, 28% of herpes encephalitis patients given acyclovir died, versus 54% given the older drug vidarabine.[3],[4],[6],[16]
  • Allopurinol (1963) blocks the body's production of uric acid, preventing the crystal deposits of gout and uric acid kidney stones, and it protects cancer patients during chemotherapy.[3],[4]
  • Colleagues at Burroughs Wellcome used the same design approach to develop AZT, which for years was the only licensed AIDS drug in the United States.[4],[7]

Impact in numbers

Elion's impact is spread across cancer, transplants, gout, infections and the way drugs are invented, so we count only the most measurable pieces and credit her conservatively. For childhood leukemia we model lives saved by modern combination chemotherapy, in which her 6-MP is a core maintenance drug, and credit her with 8%, because the cure came from many drugs, trials and doctors. For transplants we count organ recipients since 1962 but credit her with only 4%, since azathioprine opened the field while newer drugs now carry most of the load. For acyclovir we count only deaths prevented from herpes encephalitis in wealthier countries, and credit her with 20%, sharing with the chemist who first made the molecule and the doctors who tested it. We leave unquantified allopurinol for gout, azathioprine for autoimmune disease, acyclovir's relief from herpes and shingles and the design method that later produced AZT.

HealthFundamental science

Each number is the laureate’s credited share of a real-world outcome, cumulative to 2025. The whole outcome, the share of credit, and the reasoning are shown so you can check the arithmetic. Outcomes shared with other laureates are counted once on the impact page.

  • Medium confidenceDirectModeledHealth

    Children and teens cured of acute lymphoblastic leukemia by modern combination chemotherapy

    48,000–65,600

    lives saved, credited share

    That is 8% of 600,000–820,000 lives saved since 1960.

    How this number was built

    Before 6-MP, childhood ALL was nearly always fatal (median survival 3-4 months). GBD 2021: under-20 ALL cases/deaths were 62,687/48,061 in 1990 and 53,485/23,991 in 2021, so yearly survivors rose from about 14,600 to 29,500. Average 22,000 x 32 years (1990-2021) = 706,000; plus 4 x 29,500 = 118,000 (2022-2025); minus 5% of cases who might survive without modern therapy (about 104,000) = about 720,000; minus 15% for later relapses = low 600,000. High skips the relapse cut and adds rich-country survivors from 1960-1989: US about 2,500 cases a year (assumed; 3,100 today) x 10 years x average survival of 14%, 50% and 70% in the 1960s, 1970s and 1980s (60% by 1975) = 33,500, x3 for all rich countries = 100,000; 720,000 + 100,000 = 820,000. Share 0.08: 6-MP is a mainstay of modern regimens, but cures also needed other drugs, trial networks and supportive care; Hitchings shares 6-MP credit.[3],[9],[10],[11],[12]

    Sources: NobelPrize.org (Nobel Foundation); Haematologica (via PubMed Central); Our World in Data; Frontiers in Public Health (via PubMed Central); National Cancer Institute

  • Medium confidenceRippleModeledHealth

    Solid-organ transplant recipients worldwide since immunosuppressive drugs made transplants workable

    104,000–168,000

    people benefited, credited share

    That is 4% of 2.6–4.2 million people benefited since 1962.

    How this number was built

    UNOS recorded the 1 millionth US organ transplant in September 2022, with more than 40,000 a year by 2021; GODT reports 48,935 US transplants in 2024. About 3.3 more years at roughly 46,000 a year gives about 1.16 million US transplants by end-2025. The US did 28% of the world's 173,727 transplants in 2024; assuming a 25-40% US share over time gives 2.9-4.6 million worldwide. Subtracting about 10% for repeat transplants gives 2.6-4.2 million recipients. Share 0.04: azathioprine with prednisone made unrelated-donor kidney transplants workable from 1962-63 and anchored immunosuppression until cyclosporine around 1980, but most transplants since rely on newer drugs, and success also depends on surgery, tissue matching and organ preservation. Elion shares azathioprine's credit with Hitchings and with Schwartz, Dameshek, Calne and Murray, who proved its use.[3],[4],[13],[14],[15]

    Sources: NobelPrize.org (Nobel Foundation); NobelPrize.org (Nobel Assembly at Karolinska Institutet); World Journal of Surgery (via PubMed Central); United Network for Organ Sharing (UNOS); Transplantation (via PubMed Central)

  • Low confidenceDirectModeledHealth

    Deaths from herpes simplex encephalitis prevented by acyclovir in wealthier countries

    6,000–20,000

    lives saved, credited share

    That is 20% of 30,000–100,000 lives saved since 1984.

    How this number was built

    Herpes encephalitis strikes 2.2-4.3 people per million a year (Sweden, Iceland). The counterfactual is vidarabine, the prior standard drug, not no treatment: in the two head-to-head trials mortality was 28% on acyclovir vs 54% on vidarabine (Whitley 1986, US) and 19% vs 50% (Skoldenberg 1984, Sweden), a gain of 26-31 points. World Bank high-income population averaged 1.28 billion in 1985-2023. Low: 1.28B x 2.2 per million = 2,816 cases a year x 0.26 x 42 years (1984-2025) = about 30,700. High: 1.8B people with access (high-income plus an assumed 0.5B of the 2-3B in upper-middle-income countries) x 4.3 per million = 7,740 x 0.31 x 42 = about 100,800. Excludes neonatal herpes, shingles and other uses. Share 0.2: Howard Schaeffer designed and made acyclovir, Bauer and Collins tested it and Whitley and colleagues ran trials; Elion's group explained its selectivity and guided development.[3],[8],[16],[17],[18],[24]

    Sources: NobelPrize.org (Nobel Foundation); New England Journal of Medicine (PubMed record); The Lancet (PubMed record); SpringerPlus (via PubMed Central); World Bank (World Development Indicators API); Science History Institute

The double edge

Elion's drugs work because they stop cells from dividing or calm the immune system, and those same effects carry real risks. Thiopurines such as 6-MP and azathioprine can dangerously suppress the bone marrow, especially in people who inherit weak versions of the enzymes TPMT or NUDT15; doctors now use genetic tests to set safe doses. Long-term immune suppression with azathioprine raises the risk of cancers such as lymphoma, which its US label carries as a boxed warning. Allopurinol was the drug most often linked to Stevens-Johnson syndrome and toxic epidermal necrolysis, rare but life-threatening skin reactions, in a large European and Israeli study. None of this involves misconduct; these are known trade-offs of strong medicines, and later research has reduced them. There is also a credit question. Popular accounts sometimes say Elion invented acyclovir or AZT. Howard Schaeffer first made acyclovir, with Elion's group explaining how it worked, and AZT was developed by colleagues after she retired; she said she had little to do with it.

  • Moderate

    Bone marrow toxicity from thiopurines

    6-MP and azathioprine can dangerously lower blood cell counts. Patients who inherit two non-working copies of the TPMT or NUDT15 gene need only 5-10% of the usual dose to avoid severe toxicity, so preemptive genetic testing is now used to set doses.[9],[19]

  • Moderate

    Cancer risk from long-term immune suppression

    The US label for azathioprine carries a boxed warning that chronic immunosuppression with the drug increases the risk of cancer, including post-transplant lymphoma and a rare hepatosplenic T-cell lymphoma in patients with inflammatory bowel disease.[19]

  • Moderate

    Severe skin reactions to allopurinol

    In the EuroSCAR case-control study of 379 patients, allopurinol was the drug most often associated with Stevens-Johnson syndrome and toxic epidermal necrolysis, rare but life-threatening reactions. Risk was highest at doses of 200 mg a day or more and in the first eight weeks of use.[20]

Against the odds

Elion grew up in a Jewish immigrant family in New York when antisemitism was common in the United States, and it grew through the 1930s. Many private colleges used quotas that kept Jewish women out. Hunter College, free and admitting students by exam alone, took them in, and by some estimates three-quarters of its students in the 1930s were Jewish. Elion went there because her father had gone bankrupt in the 1929 crash, and she believed that without a free college she might never have studied at all. She graduated with top honors in 1937, into the Depression, and hit a second wall: laboratories would not hire women. Fifteen graduate schools turned down her requests for financial aid. She tried secretarial school, taught, and worked unpaid for a chemist while the company's president told antisemitic jokes every day. In 1941 her fiancé died of a heart infection that penicillin would soon cure, which hardened her resolve. Only the wartime shortage of male chemists opened research jobs to her. Later, a graduate school made her choose between her job and a doctorate, and she never earned a PhD. Even at the Nobel stage, a committee member reportedly asked whether she had really contributed. She was not a refugee and never faced the violent persecution of Jews in Europe; her obstacles were poverty, sexism and everyday American antisemitism.

  • 1929

    Poverty

    Her father went bankrupt in the 1929 stock market crash. Elion said that had Hunter College not been free, she might never have received a higher education.[2],[5]

  • —

    Quota

    Antisemitism was common in the United States and grew through the 1930s. Restrictive quotas at many private colleges kept Jewish women out; Hunter College, free and admitting by exam, absorbed them, and by some estimates 75% of its students were Jewish in that decade.[21],[22]

  • 1937

    Discrimination

    After graduating summa cum laude, she was refused financial aid by 15 graduate schools and turned down for laboratory jobs because she was a woman. She later recalled that nobody took her seriously.[2],[6],[7]

  • —

    Discrimination

    While volunteering in a chemistry lab to gain experience after college, she endured daily antisemitic jokes from the company's president.[7]

  • 1941

    Other

    Her fiancé, Leonard Canter, died of bacterial endocarditis, a heart infection. She said the loss showed her that finding treatments was a matter of life and death, and she never married.[7]

  • —

    Other

    After two years of night classes toward a doctorate, her graduate school told her to study full time or leave. She chose to keep her research job and never earned a PhD.[2],[7]

Jewish background

Both parents JewishCulturally Jewish

Elion was born in New York to Eastern European Jewish immigrants. Her father, Robert, a dentist, came from Lithuania at 12 and descended from a long line of rabbis. Her mother, Bertha Cohen, came alone at 14 from the part of the Russian Empire that became Poland. Elion credited her parents' drive to educate their children to their Jewish background: she said immigrant Jews saw education as their route to success and held the most learned people in the highest regard. She studied at Hunter College, then a mainly Jewish women's college. The biographies consulted do not describe religious practice in her adult life, so her tie to Jewish identity appears mainly cultural.[2],[5],[7],[21],[23]

Key dates

  1. January 23, 1918

    Born in New York City to Jewish immigrant parents: a dentist father from Lithuania and a mother from the part of Russia that became Poland.[1],[2],[5]

  2. 1933

    After her grandfather dies of cancer, enters tuition-free Hunter College at 15 to study chemistry and fight the disease.[2],[5],[6]

  3. 1937

    Graduates from Hunter summa cum laude and Phi Beta Kappa, but finds graduate aid and lab jobs closed to women.[5],[7]

  4. 1941

    Earns a master's degree in chemistry from New York University, doing her research at night; her fiancé dies of a heart infection.[2],[7]

  5. 1944

    Joins the Wellcome Research Laboratories of Burroughs Wellcome as assistant to George Hitchings, beginning a partnership of more than 30 years.[6],[7],[8]

  6. 1950

    Develops thioguanine and, in 1951, 6-mercaptopurine, purine look-alikes that attack leukemia cells.[3],[4]

  7. 1953

    The US Food and Drug Administration approves 6-MP for childhood acute leukemia, little more than two years after it was made.[3],[6]

  8. 1962

    In Boston, a kidney from an unrelated donor works for over a year in a patient given her drug azathioprine (made in 1957); with prednisone it soon makes such transplants workable.[3],[4],[13]

  9. 1967

    Becomes head of the Department of Experimental Therapy at Burroughs Wellcome, a post she holds until 1983.[2],[8]

  10. 1977

    Her group publishes how acyclovir selectively blocks herpes viruses; it becomes the first antiviral drug to attack them while largely sparing healthy cells.[3],[4],[5],[6],[8]

  11. 1983

    Retires as department head but stays on as scientist emeritus and becomes a research professor at Duke University, mentoring medical students.[2],[6]

  12. 1988

    Shares the Nobel Prize in Physiology or Medicine with George Hitchings and James Black for discovering important principles for drug treatment.[1],[4]

  13. 1991

    Receives the National Medal of Science and becomes the first woman inducted into the National Inventors Hall of Fame.[5],[6],[7]

  14. February 21, 1999

    Dies in Chapel Hill, North Carolina, aged 81, after collapsing on her daily walk.[1],[6]

Sources

  1. 1.Gertrude B. Elion - Facts · NobelPrize.org (Nobel Prize Outreach)
  2. 2.Gertrude B. Elion - Biographical (autobiography from Les Prix Nobel 1988) · NobelPrize.org (Nobel Foundation), 1988
  3. 3.The Purine Path to Chemotherapy (Nobel Lecture, 8 December 1988) · NobelPrize.org (Nobel Foundation), 1988
  4. 4.The Nobel Prize in Physiology or Medicine 1988 - Press release · NobelPrize.org (Nobel Assembly at Karolinska Institutet), 1988
  5. 5.Gertrude Elion (Shalvi/Hyman Encyclopedia of Jewish Women), by Kristine Larsen · Jewish Women's Archive, 2009
  6. 6.Gertrude B. Elion, 1918-1999: Biographical Memoirs Volume 78, by Mary Ellen Avery · National Academy of Sciences (National Academies Press), 2000
  7. 7.Women of Valor: Gertrude Elion · Jewish Women's Archive
  8. 8.George Hitchings and Gertrude Elion (Scientific Biographies) · Science History Institute
  9. 9.Improving the treatment of childhood acute lymphoblastic leukemia by optimizing the use of 70-year-old drugs (Evans WE, commentary) · Haematologica (via PubMed Central), 2021
  10. 10.Childhood leukemia: how a deadly cancer became treatable (Saloni Dattani) · Our World in Data, 2025
  11. 11.Global, regional, and national burden of children and adolescents with acute lymphoblastic leukemia from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021 · Frontiers in Public Health (via PubMed Central), 2025
  12. 12.Childhood Acute Lymphoblastic Leukemia Treatment (PDQ), Health Professional Version · National Cancer Institute
  13. 13.History of Clinical Transplantation (Starzl TE, World J Surg 24:759-782) · World Journal of Surgery (via PubMed Central), 2000
  14. 14.U.S. reaches historic milestone of 1 million transplants · United Network for Organ Sharing (UNOS), 2022
  15. 15.Organ Donation and Transplantation Worldwide: The Global Observatory on Donation and Transplantation 2024 Report · Transplantation (via PubMed Central), 2026
  16. 16.Vidarabine versus acyclovir therapy in herpes simplex encephalitis (Whitley RJ et al., N Engl J Med 314:144-149) · New England Journal of Medicine (PubMed record), 1986
  17. 17.Herpes simplex encephalitis in Iceland 1987-2011 (Dagsdottir et al., SpringerPlus 3:524) · SpringerPlus (via PubMed Central), 2014
  18. 18.Population, total (SP.POP.TOTL): high-income and upper-middle-income countries, 1985-2023 · World Bank (World Development Indicators API), 2024
  19. 19.IMURAN (azathioprine) prescribing information · US Food and Drug Administration, 2024
  20. 20.Allopurinol is the most common cause of Stevens-Johnson syndrome and toxic epidermal necrolysis in Europe and Israel (Halevy S et al., J Am Acad Dermatol 58:25-32) · Journal of the American Academy of Dermatology (PubMed record), 2008
  21. 21.Hunter College (Shalvi/Hyman Encyclopedia of Jewish Women), by Katharina Kroo Grunfeld · Jewish Women's Archive, 2009
  22. 22.How did the United States government and American people respond to Nazism? · United States Holocaust Memorial Museum, Holocaust Encyclopedia
  23. 23.Gertrude Elion, Nobelist and Inventor Without a PhD · Jewish Heritage North Carolina, 2025
  24. 24.Acyclovir versus vidarabine in herpes simplex encephalitis: randomised multicentre study in consecutive Swedish patients (Skoldenberg B et al., Lancet 2:707-711) · The Lancet (PubMed record), 1984

Fact-checked on September 24, 2026 by a separate AI fact-checking pass that re-opened the sources, with 10 corrections made. How we check

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