期刊
PHARMACOGENOMICS & PERSONALIZED MEDICINE
卷 12, 期 -, 页码 33-45出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/PGPM.S192924
关键词
acute lymphoblastic leukemia; late adverse effects; skeletal muscle deficit; genetic association study; whole exome sequencing
资金
- Canadian Institutes of Health Research
- Cancer Research Society Inc. (CRS)
- Garron Family Cancer Center of the Hospital for Sick Children
- Paediatric Oncology Groups of Ontario (POGO)
- Canadian Cancer Society Research Institute (CCSRI)
- C17 Research Network (C17)
- Sainte-Justine Hospital Foundation
- FRQS Applied Medical Genetics Network
Background: Although 80% of childhood acute lymphoblastic leukemia (ALL) cases are cured with current treatment protocols, exposure to chemotherapeutics or radiation therapy during a vulnerable period of child development has been associated with a high frequency of late adverse effects (LAE). Previous observations suggest important skeletal muscle size, density and function deficits in ALL survivors. Purpose: Given that only a fraction of all patients will suffer from this particular complication, we investigated whether it could be predicted by genetic markers. Patients and methods: We analysed associations between skeletal muscle force (Fmax) and power (Pmax) and germline genetic variants from 1039 genes derived through whole-exome sequencing. Top-ranking association signals retained after correction for multiple testing were confirmed through genotyping, and further analysed through stratified analyses and multivariate models. Results: Our results show that skeletal muscle function deficit is associated with two common single nucleotide polymorphisms (SNPs) (rs2001616DUOX2, P=0.0002 (Pmax) and rs41270041ADAMTS4, P=0.02 (Fmax)) and two rare ones located in the ALOX15 gene (P=0.001 (Pmax)). These associations were further modulated by sex, body mass index and risk groups, which reflected glucocorticoid dose and radiation therapy (P <= 0.02). Conclusion: Occurrence of muscle function deficit in childhood ALL is thus strongly modulated by variations in the DUOX2, ADAMTS4 and ALOX15 genes, which could lead to personalized prevention strategies in childhood ALL survivors.
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