| |
|
|
|
|
|
|
|||
|
Blood, 15 June 2006, Vol. 107, No. 12, pp. 4871-4879. Prepublished online as a Blood First Edition Paper on February 28, 2006; DOI 10.1182/blood-2005-08-3272.
Submitted August 12, 2005
Department of Human Anatomy, Faculty of Medicine, University of Barcelona, Barcelona, Spain * Corresponding author; email: aurbano{at}clinic.ub.es.
Current prognostic factors for acute myeloblastic leukemia (AML) are not sufficient to accurately predict the group of patients in the intermediate-risk category who will successfully respond to treatment. Distinct patterns of inherited functional genomic polymorphisms might explain part of these heterogeneous prognoses. We used the allelic discrimination method to identify polymorphisms in GSTT1, SULT1C2, CDA, SXR (drug metabolic pathways), XPD, XPA, XPG, ERCC1, TOP2A (DNA repair), VEGF (angiogenesis), and MDR1 genes (multidrug resistance) in 110 adult patients with intermediate-risk AML, enrolled in the CETLAM-99 prospective trial. A multivariate prognostic model adjusted for age, WBC count, FAB group, cytogenetics, MLL rearrangement, internal tandem duplication of FLT3 (FLT3-ITD), induction courses to achieve complete remission, and germline polymorphisms, was used to detect independent risk factors associated with clinical outcome. This analysis showed an increased risk of refractoriness to chemotherapy in the group of patients with XPA variant alleles (RR=14; p=0.02). In the same model, increased relapse risk was associated with SULT1C2 heterozygosity (RR=4.1; p=0.004), FLT3-ITD (RR 3.3; p=0.003), and MDR1 variant alleles (RR=2.4; p=0.02). Adverse prognostic variables for overall survival were XPA (RR=3.4; p=0.02) and MDR1 (RR=2.1; p=0.02) variant alleles, and WBC count (RR=2.1; p=0.02). These finding might be useful in selecting risk-adapted treatment strategies in intermediate-risk AML.
This article has been cited by other articles:
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Copyright © 2006 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||