American Journal of Pharmacogenomics

, Volume 4, Issue 5, pp 331–341

Polymorphisms in Genes Involved in the Corticosteroid Response and the Outcome of Childhood Acute Lymphoblastic Leukemia

Authors

  • Isabelle Fleury
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
  • Melanie Primeau
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
  • Agnes Doreau
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
  • Irina Costea
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
  • Albert Moghrabi
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
    • Department of PediatricsUniversity of Montreal
  • Daniel Sinnett
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
    • Department of PediatricsUniversity of Montreal
    • Research CenterSainte-Justine Hospital, Centre Hospitalier Universitaire Mère-Enfant
    • Department of PediatricsUniversity of Montreal
Original Research Article

DOI: 10.2165/00129785-200404050-00006

Cite this article as:
Fleury, I., Primeau, M., Doreau, A. et al. Am J Pharmacogenomics (2004) 4: 331. doi:10.2165/00129785-200404050-00006

Abstract

Background

Considerable variability in sensitivity to corticosteroids (CS) has been observed among individuals with regard to both the natural and synthetic compounds. The role of genetic polymorphisms in modulating CS function, and hence in disease susceptibility, has been extensively analyzed. Their impact on therapeutic response still remains to be explored. The role of cytochrome P450 (CYP) 3A4 in corticosteroid metabolism, and that of the glucocorticoid receptor (NR3C1) in regulation of responsive genes, renders CYP3A4 and NR3C1 polymorphisms as potential candidates for pharmacogenetic analysis.

Aim

The aim of the study was to analyze the role of these polymorphisms in the outcome of a disease treated with CS drugs.

Methods

Towards this aim we analyzed the CYP3A4–290A/G substitution and three NR3C1 polymorphisms (200G/A, 1220A/G and BclI RFLP) in 222 children with acute lymphoblastic leukemia (ALL) whose treatment protocols, among other components, contained corticosteroid drugs.

Results

The analysis of survival probabilities in relation to the indicated genotypes showed only an association between homozygosity for allele G of the NR3C1 BclI RFLP polymorphism and overall survival (univariate and multivariate hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.0, 7.6 and 5.2, 95% CI 1.4, 18.9, respectively). The association reflects a correlation with disease progression and prognosis, and may vary depending on risk of relapse.

Conclusion

A reduction in survival probability in children with ALL was associated with homozygosity for G allele of the NR3C1 BclI RFLP polymorphism, particularly in certain patient subgroups. Further analysis is required to replicate this finding and to understand the mechanism underlying the observed association.

Copyright information

© Adis Data Information BV 2004