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在一项针对日本急性淋巴细胞白血病儿童的全基因组关联研究中,NUDT15 基因变异与 6-巯基嘌呤耐受性的显著相关。

Prominence of NUDT15 genetic variation associated with 6-mercaptopurine tolerance in a genome-wide association study of Japanese children with acute lymphoblastic leukaemia.

机构信息

Division of Medical Safety Sciences, National Institute of Health Sciences, Kanagawa, Japan.

Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.

出版信息

Br J Haematol. 2022 Oct;199(2):260-269. doi: 10.1111/bjh.18405. Epub 2022 Aug 12.

Abstract

Inherited genetic variation is associated with 6-mercaptopurine (6-MP) dose reduction and frequent toxicities induced by 6-MP. However, the tolerable dose for 6-MP is not fully predicted by the known variation in NUDT15 and TPMT among Asian children with acute lymphoblastic leukaemia (ALL). We performed a genome-wide association study (GWAS) related to 6-MP dose among Japanese children with ALL. This GWAS comprised 224 patients previously enrolled in Tokyo Children's Cancer Study Group clinical studies with replication attempted in 55 patients. Genome-wide single nucleotide polymorphism (SNP) genotypes were evaluated for association with average 6-MP dose during the initial 168 days of maintenance therapy. Possible associations were observed across five gene-coding regions, among which only variants at 13q14.2 were significant and replicated genome-wide (rs116855232, NUDT15, β = -10.99, p = 3.7 × 10 ). Notable findings were observed for variants in AFF3 (rs75364948, p = 2.05 × 10 ) and CHST11 (rs1148407, p = 2.09 × 10 ), but were not replicated possibly due to small numbers. A previously reported candidate SNP in MTHFR was associated with higher average 6-MP dose (rs1801133, p = 0.045), and FOLH1 (rs12574928) was associated in an evaluation of candidate regions (p  = 0.013). This study provides strong evidence that rs116855232 in NUDT15 is the genetic factor predominantly associated with 6-MP tolerable dose in children in Japan.

摘要

遗传变异与 6-巯基嘌呤(6-MP)剂量减少和 6-MP 诱导的频繁毒性有关。然而,在亚洲急性淋巴细胞白血病(ALL)儿童中,已知 NUDT15 和 TPMT 的变异并不能完全预测 6-MP 的耐受剂量。我们进行了一项与日本 ALL 儿童 6-MP 剂量相关的全基因组关联研究(GWAS)。该 GWAS 包括 224 名先前参加东京儿童癌症研究组临床研究的患者,并在 55 名患者中尝试了复制。在维持治疗的最初 168 天内,评估了全基因组单核苷酸多态性(SNP)基因型与平均 6-MP 剂量的关联。在五个基因编码区域中观察到了可能的关联,其中只有 13q14.2 上的变异是显著的,并在全基因组范围内复制(rs116855232,NUDT15,β=-10.99,p=3.7×10)。在 AFF3(rs75364948,p=2.05×10)和 CHST11(rs1148407,p=2.09×10)中观察到了显著的变异,但由于数量较少,没有复制。MTHFR 中先前报道的候选 SNP 与较高的平均 6-MP 剂量相关(rs1801133,p=0.045),并且在候选区域的评估中,FOLH1(rs12574928)也相关(p=0.013)。这项研究提供了强有力的证据,表明 NUDT15 中的 rs116855232 是与日本儿童 6-MP 耐受剂量主要相关的遗传因素。

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