Pharmacogenetics of the Central Nervous System-Toxicity and Relapse Affecting the CNS in Pediatric Acute Lymphoblastic Leukemia

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2021 Jun 2

PMID 34066083

Authors

Judit C Sagi

Andras Gezsi

Balint Egyed

Zsuzsanna Jakab

Noemi Benedek

Andishe Attarbaschi

Stefan Kohrer

Jakub Sipek

Lucie Winkowska

Marketa Zaliova

Stavroula Anastasopoulou

Benjamin Ole Wolthers

Susanna Ranta

Csaba Szalai

Gabor T Kovacs

Agnes F Semsei

Daniel J Erdelyi

Affiliations

Soon will be listed here.

Abstract

Despite improving cure rates in childhood acute lymphoblastic leukemia (ALL), therapeutic side effects and relapse are ongoing challenges. These can also affect the central nervous system (CNS). Our aim was to identify germline gene polymorphisms that influence the risk of CNS events. Sixty single nucleotide polymorphisms (SNPs) in 20 genes were genotyped in a Hungarian non-matched ALL cohort of 36 cases with chemotherapy related acute toxic encephalopathy (ATE) and 544 controls. Five significant SNPs were further analyzed in an extended Austrian-Czech-NOPHO cohort ( = 107 cases, = 211 controls) but none of the associations could be validated. Overall populations including all nations' matched cohorts for ATE ( = 426) with seizure subgroup ( = 133) and posterior reversible encephalopathy syndrome (PRES, = 251) were analyzed, as well. We found that patients with rs1045642, rs1128503 or rs2032582 TT genotypes were more prone to have seizures but those with rs1045642 TT developed PRES less frequently. The same SNPs were also examined in relation to ALL relapse on a case-control matched cohort of 320 patients from all groups. Those with rs1128503 CC or rs2032582 GG genotypes showed higher incidence of CNS relapse. Our results suggest that blood-brain-barrier drug transporter gene-polymorphisms might have an inverse association with seizures and CNS relapse.

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