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Frikha I, Frikha R, Medhaffer M, Charfi H, Turki F, Elloumi M. Impact of CYP1A1 variants on the risk of acute lymphoblastic leukemia: evidence from an updated meta-analysis. Blood Res 2024; 59:9. [PMID: 38485870 PMCID: PMC10917727 DOI: 10.1007/s44313-024-00007-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/24/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE Our study aimed to investigate the association between cytochrome P450 1A1 (CYP1A1) polymorphisms (T3801C and A2455G) and acute lymphoblastic leukemia (ALL) risk, considering genetic models and ethnicity. MATERIALS AND METHODS PubMed, Embase, Web of Knowledge, Scopus, and the Cochrane electronic databases were searched using combinations of keywords related to CYP1A1 polymorphisms and the risk of ALL. Studies retrieved from the database searches underwent screening based on strict inclusion and exclusion criteria. RESULTS In total, 2822 cases and 4252 controls, as well as 1636 cases and 2674 controls of the C3801T and A2455G variants of CYP1A1, respectively, were included in this meta-analysis. The T3801C polymorphism of CYP1A1 significantly increases the risk of ALL, particularly those observed in Asian and Hispanic populations, independent of age. Similarly, the A2455G polymorphism of CYP1A1 plays a significant role in the susceptibility to ALL in all genetic models, except the heterozygous form. This association was observed mainly in mixed populations and in both children and adults (except in the heterozygous model). CONCLUSION Our comprehensive analysis indicates that the T3801 and A2455G polymorphisms of CYP1A1 may increase the risk of ALL depending on ethnicity. Therefore, both variants should be considered promising biomarkers for ALL risk. Further large-scale investigations are necessary to assess other factors, such as gene-gene or gene-environment interactions.
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Affiliation(s)
- Imen Frikha
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Department of Hematology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Rim Frikha
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
- Department of Medical Genetics, Hedi Chaker Hospital, Sfax, Tunisia.
| | - Moez Medhaffer
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Department of Hematology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Hanen Charfi
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Department of Hematology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Fatma Turki
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Department of Medical Genetics, Hedi Chaker Hospital, Sfax, Tunisia
| | - Moez Elloumi
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Department of Hematology, Hedi Chaker Hospital, Sfax, Tunisia
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Kintossou AK, Blanco-Lopez J, Iguacel I, Pisanu S, Almeida CCB, Steliarova-Foucher E, Sierens C, Gunter MJ, Ladas EJ, Barr RD, Van Herck K, Kozlakidis Z, Huybrechts I. Early Life Nutrition Factors and Risk of Acute Leukemia in Children: Systematic Review and Meta-Analysis. Nutrients 2023; 15:3775. [PMID: 37686807 PMCID: PMC10489830 DOI: 10.3390/nu15173775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Acute leukemia commonly occurs in young children with peak incidence at the age of 2-5 years. However, the etiology is still unclear and many preventable risk factors still deserve to be reviewed. The focus of this systematic review and meta-analysis is to summarize the evidence concerning early life nourishment (breastfeeding, early life diet), neonatal vitamin K administration and the risk of acute leukemia. All epidemiological studies published up to June 2023 and assessing diet-related risk factors for childhood acute leukemia were identified in two electronic databases (PubMed and Web of Science), with no limits on publication year or language. A total of 38 studies (37 case-control studies and 1 study with pooled analysis) were included. The published risk estimates were combined into a meta-analysis using the Generic Inverse Variance method. The current evidence shows that breastfeeding (yes vs. no) has a protective effect against acute lymphoblastic leukemia (odds ratio = 0.85; 95% CI, 0.76-0.94). Evidence related to the role of other studied factors (foods and supplements) is inconclusive. Further research into the potential role of diet in early life and the risk of acute leukemia is needed to develop prevention strategies at population level. Review Registration: PROSPERO registration no. CRD42019128937.
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Affiliation(s)
- Ambroise Kouame Kintossou
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
- Biobank, Pasteur Institute of Côte d’Ivoire, Abidjan 01 BP 490, Côte d’Ivoire
| | - Jessica Blanco-Lopez
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Isabel Iguacel
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Silvia Pisanu
- Section of Microbiology and Virology, Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | | | - Eva Steliarova-Foucher
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Ciska Sierens
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (C.S.); (K.V.H.)
| | - Marc J. Gunter
- Faculty of Medicine, School of Public Health, Imperial College London, London SW7 2AZ, UK;
| | - Elena J. Ladas
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Ronald D. Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, ON L8S 4L7, Canada;
| | - Koen Van Herck
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium; (C.S.); (K.V.H.)
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
| | - Inge Huybrechts
- International Agency for Research on Cancer, 69007 Lyon, France; (A.K.K.); (E.S.-F.); (Z.K.); (I.H.)
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Gene-Gene Interaction Study Between Genetic Polymorphisms of Folate Metabolism and MTR SNPs on Prognostic Features Impact for Breast Cancer. Rep Biochem Mol Biol 2022; 11:89-101. [PMID: 35765535 PMCID: PMC9208558 DOI: 10.52547/rbmb.11.1.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/25/2021] [Indexed: 01/11/2023]
Abstract
Background Breast Cancer (BC), the second leading cause of cancer mortality after lung cancer and varied across the world due to genetic and environmental factors. In this study, we evaluated the interaction between the polymorphisms in genes encoding enzymes of folate metabolism: methylenetetrahydrofolate reductase (MTHFR), methionine synthesis reductase (MTR) with the BC prognostic factors. Methods This study was conducted on 160 Egyptian subjects, 60 controls and 100 cases. Sequencing, RFLP analysis in addition to statistical analysis including Chi-squared test, haplotype analysis was used to evaluate associations with BC risk and its clinicopathological parameters. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression. Results Strong significant association with breast cancer risk was observed for the haplotype (T-C-G) of MTHFR C677T/ MTHFR A1289C and MTRA2576G and hormonal receptor expression (ER-/PR-/HER2+), bigger and advanced tumor and metastatic lymph nodes. However, no significant difference was observed for age. Conclusion The combination of SNPs from MTHFR and MTR genes has a more synergistically genetic effect on BC disease progression. These SNPs could be used as tumor aggressiveness markers among Egyptian females with BC and could help in saving money and time.
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Zhu X, Liu Y, Chen G, Guo Q, Zhang Z, Zhao L, Wei R, Yin X, Zhang Y, Wang B, Li X. Association between NAT2 polymorphisms and acute leukemia risk: A meta-analysis. Medicine (Baltimore) 2019; 98:e14942. [PMID: 30896661 PMCID: PMC6709067 DOI: 10.1097/md.0000000000014942] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND N-acetyl-transferase 2 (NAT2) polymorphisms have been demonstrated to be associated with acute leukemia (AL); however, the results remain controversial. The present meta-analysis was performed to provide more precise results. METHODS Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were used to identify eligible studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between NAT2 polymorphisms and AL risk. RESULTS Increased risk was found under both heterozygous (OR 1.24, 95% CI 1.02-1.51) and recessive model (OR 1.28, 95% CI 1.06-1.55) for rs1801280. The slow acetylator phenotype (OR 1.22, 95% CI 1.07-1.40) also increased AL risk. Subgroup analysis demonstrated that rs1801280 increased AL risk under the recessive model (OR 1.14, 95% CI 0.93-1.41) in Caucasian population and the co-dominant (OR 1.77, 95% CI 1.40-2.23), homozygous (OR 3.06, 95% CI 1.88-4.99), dominant (OR 2.22, 95% CI 1.56-3.17), recessive model (OR 2.06, 95% CI 1.35-3.16) in the Mixed populations. Association between rs1799929 and decreased AL risk was found in the co-dominant (OR 0.82, 95% CI 0.70-0.97), homozygous (OR 0.65, 95% CI 0.46-0.93), heterozygous (OR 0.71, 95% CI 0.51-1.00), and the recessive model (OR 0.68, 95% CI 0.49-0.94) in the Caucasian group. As for rs1799931, the same effects were found in the co-dominant (OR 0.68, 95% CI 0.49-0.94) and the dominant model (OR 0.68, 95% CI 0.48-0.97) in the mixed group. CONCLUSION rs1801280 and the slow acetylator phenotype are risk factors for AL.
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Affiliation(s)
- Xiaoxiao Zhu
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
| | - Yanbing Liu
- Breast Cancer Center, Shandong Cancer Hospital Affiliated to Shandong University
| | | | - Qiang Guo
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
| | - Zhen Zhang
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
| | - Lin Zhao
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
| | - Ran Wei
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
| | - Xunqiang Yin
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences
| | - Yunhong Zhang
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences
| | - Bin Wang
- Department of peripheral vascular disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xia Li
- Laboratory for molecular immunology, Institute of Basic Medicine, Shandong Academy of Medical Sciences
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Methionine synthase A2756G polymorphism influences pediatric acute lymphoblastic leukemia risk: a meta-analysis. Biosci Rep 2019; 39:BSR20181770. [PMID: 30559146 PMCID: PMC6331679 DOI: 10.1042/bsr20181770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/02/2018] [Accepted: 12/06/2018] [Indexed: 12/31/2022] Open
Abstract
Plenty of studies have investigated the effect of methionine synthase (MTR) A2756G polymorphism on risk of developing pediatric acute lymphoblastic leukemia (ALL), but the available results were inconsistent. Therefore, a meta-analysis was conducted to derive a more precise estimation of the association between MTR A2756G polymorphism and genetic susceptibility to pediatric ALL. The PubMed, Embase, Google Scholar, Web of Science, ScienceDirect, Wanfang Databases and China National Knowledge Infrastructure were systematically searched to identify all the previous published studies exploring the relationship between MTR A2756G polymorphism and pediatric ALL risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to evaluate the strength of association. Sensitivity analysis and publication bias were also systematically assessed. This meta-analysis finally included ten available studies with 3224 ALL cases and 4077 matched controls. The results showed that there was significant association between MTR A2756G polymorphism and risk of pediatric ALL in overall population (AG vs. AA: OR = 1.13, 95%CI = 1.02-1.26, P = 0.02; AG+GG vs. AA: OR = 1.13, 95%CI = 1.02-1.25, P = 0.01; G allele vs. A allele: OR = 1.10, 95%CI = 1.01-1.20, P = 0.03). In the stratification analyses by ethnicity, quality score and control source, significant association was found in Caucasians, population-based designed studies and studies assigned as high quality. In conclusion, this meta-analysis suggests that MTR A2756G polymorphism may influence the development risk of pediatric ALL in Caucasians. Future large scale and well-designed studies are required to validate our findings.
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Bonaventure A, Orsi L, Rudant J, Goujon-Bellec S, Leverger G, Baruchel A, Bertrand Y, Nelken B, Pasquet M, Michel G, Sirvent N, Chastagner P, Ducassou S, Thomas C, Besse C, Hémon D, Clavel J. Genetic polymorphisms of Th2 interleukins, history of asthma or eczema and childhood acute lymphoid leukaemia: Findings from the ESCALE study (SFCE). Cancer Epidemiol 2018; 55:96-103. [PMID: 29883839 DOI: 10.1016/j.canep.2018.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Previous studies on the putative role of allergy in the aetiology of childhood leukaemia have reported contradictory results. The present study aimed to analyse the relation between a medical history of asthma or eczema and childhood acute lymphoid leukaemia (ALL) in light of potential candidate gene-environment interactions. METHODS Analyses were based on a subset of 434 cases of ALL and 442 controls successfully genotyped and of European ancestry children enrolled in a French population-based case-control study conducted in 2003-2004. Information about medical history was obtained during a standardized interview with the mothers. Candidate polymorphisms in genes of the Th2 cytokines IL4, IL10, IL13 and IL4-receptor, were genotyped or imputed. RESULTS None of the variant alleles were directly associated with childhood acute lymphoid leukaemia. A medical history of asthma or eczema was reported more often in the control group (OR = 0.7 [0.5-1.0]). This association was mostly seen in the group of children not carrying the IL13-rs20541 variant allele (Interaction Odds Ratio IOR 1.9, p-interaction = 0.07) and in those carrying the IL10 triple variant haplotype (IOR 0.5, p-interaction = 0.04). No interaction was observed with the candidate polymorphisms in IL4 and IL4R. CONCLUSION This study provides a new insight into the relationship between allergic symptoms and childhood acute lymphoid leukaemia, by suggesting this inverse association could be limited to children carrying certain genetic polymorphisms. If confirmed, these results could help better understand the biological mechanisms involved in the development of childhood acute lymphoid leukaemia.
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Affiliation(s)
- A Bonaventure
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France; Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - L Orsi
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France
| | - J Rudant
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
| | - S Goujon-Bellec
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
| | - G Leverger
- AP-HP, Hôpital Armand Trousseau, Université Paris 6 Pierre et Marie Curie, Paris, France
| | - A Baruchel
- AP-HP, Hôpital Robert Debré, Université Paris 7 Denis Diderot, Paris, France
| | - Y Bertrand
- Institut d'Hémato-Oncologie Pédiatrique, Lyon, France
| | - B Nelken
- CHU de Lille, Hôpital Jeanne de Flandre, Lille, France
| | - M Pasquet
- Hôpital des Enfants, Toulouse, France
| | - G Michel
- AP-HM, Hôpital la Timone, Marseille, France
| | - N Sirvent
- Hôpital Arnaud de Villeneuve, CHRU, Montpellier, France
| | | | - S Ducassou
- Haematology and Oncology, Childrens' Hospital, Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - C Thomas
- Service d'onco-hématologie pédiatrique, CHU de Nantes, France
| | - C Besse
- Commissariat à l'Energie Atomique (CEA) Genomics Institute-Centre National de Génotypage, Evry Cedex, France
| | - D Hémon
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France
| | - J Clavel
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS U1153, EPICEA-Epidémiologie des cancers de l'enfant et de l'adolescent, Villejuif, France; INSERM, RNCE-National Registry of Childhood Cancers, Villejuif, France
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Brisson GD, de Almeida Lopes B, Andrade FG, Dos Santos Bueno FV, Sardou-Cezar I, de Aguiar Gonçalves BA, Terra-Granado E, Paraguassú-Braga FH, Pombo-de-Oliveira MS. EPHX1 rs1051740 T>C (Tyr113His) is strongly associated with acute myeloid leukemia and KMT2A rearrangements in early age. Arch Toxicol 2018; 92:2001-2012. [PMID: 29605894 DOI: 10.1007/s00204-018-2198-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/21/2018] [Indexed: 01/18/2023]
Abstract
Experimental and epidemiological data have shown that acute myeloid leukemia in early-age (i-AML) originates prenatally. The risk association between transplacental exposure to benzene metabolites and i-AML might be influenced by genetic susceptibility. In this study, we investigated the relationship between genetic polymorphisms in CYP2E1, EPHX1, MPO, NQO1, GSTM1 and GSTT1 genes, and i-AML risk. The study included 101 i-AMLs and 416 healthy controls. Genomic DNA from study subjects was purified from bone marrow or peripheral blood aspirates and genotyped for genetic polymorphisms by real-time PCR allelic discrimination, Sanger sequencing and multiplex PCR. Crude and adjusted odds ratios (OR, adjOR, respectively) with 95% confidence intervals (95% CI) were assessed using unconditional logistic regression to estimate the magnitude of risk associations. EPHX1 rs1051740 T>C was associated with i-AML risk under the co-dominant (adjOR 3.04, P = 0.003) and recessive (adjOR 2.99, P = 0.002) models. In stratified analysis, EPHX1 rs1051740 was associated with increased risk for i-AML with KMT2A rearrangement (adjOR 3.06, P = 0.045), i-AML with megakaryocytic differentiation (adjOR 5.10, P = 0.008), and i-AML with type I mutation (adjOR 2.02, P = 0.037). EPHX1 rs1051740-rs2234922 C-G haplotype was also associated with increased risk for i-AML (adjOR 2.55, P = 0.043), and for i-AML with KMT2A rearrangement (adjOR 3.23, P = 0.034). Since EPHX1 enzyme is essential in cellular defense against epoxides, the diminished enzymatic activity conferred by the variant allele C could explain the risk associations found for i-AML. In conclusion, EPHX1 rs1051740 plays an important role in i-AML's genetic susceptibility by modulating the carcinogenic effects of epoxide exposures in the bone marrow.
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Affiliation(s)
- Gisele Dallapicola Brisson
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Bruno de Almeida Lopes
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Francianne Gomes Andrade
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Filipe Vicente Dos Santos Bueno
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Ingrid Sardou-Cezar
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Bruno Alves de Aguiar Gonçalves
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Eugênia Terra-Granado
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil
| | - Flávio Henrique Paraguassú-Braga
- Centro de Processamento e Armazenamento Celular, Banco de Sangue de Cordão Umbilical, Centro de Transplante e Terapia Celular, Instituto Nacional de Câncer (INCA), Praça da Cruz Vermelha 23, Rio de Janeiro, RJ, Brazil
| | - Maria S Pombo-de-Oliveira
- Pediatric Hematology-Oncology Research Program, Research Center, Instituto Nacional de Câncer (INCA), Rua André Cavalcanti 37, Rio de Janeiro, RJ, Brazil.
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He H, Zhai X, Liu X, Zheng J, Zhai Y, Gao F, Chen Y, Lu J. Associations of NQO1 C609T and NQO1 C465T polymorphisms with acute leukemia risk: a PRISMA-compliant meta-analysis. Onco Targets Ther 2017; 10:1793-1801. [PMID: 28367062 PMCID: PMC5370065 DOI: 10.2147/ott.s132503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective The NAD(P)H:quinone oxidoreductase (NQO1) C609T and C465T polymorphisms have been widely thought to be associated with the risk of acute leukemia (AL) in recent years, but the correlations are still unclear. A meta-analysis is generally acknowledged as one of the best methods for secondary research, and so it was applied in this study with the aim of elucidating how the NQO1 C609T and C465T polymorphisms are related to the risk of AL. Methods Relevant studies were searched in the PubMed, EMBASE, CNKI, and Wanfang databases, and the obtained data were analyzed using Stata (version 12.1). The allele-contrast model was applied, and odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate relationship strengths. Meta-regression was used to identify sources of heterogeneity, and subgroup analyses were conducted. Publication bias was analyzed using funnel plots, with the trim-and-fill method used to analyze the effect of publication bias on pooled results. In addition, sensitivity analysis, the fail-safe number method, and cumulative analysis by publication year were performed to measure the stability of the obtained results. Results This meta-analysis included 28 relevant studies involving 5,953 patients and 8,667 controls. Overall, the C609T polymorphism was associated with the risk of acute lymphoblastic leukemia (ALL; OR =1.18, 95% CI =1.00–1.39, P=0.05). Meanwhile, race was found to be a potential source of heterogeneity for the relationship between the C609T polymorphism and acute myeloid leukemia (AML) risk, and the subgroup analysis identified the C609T polymorphism as a risk factor for AML in Asians (OR =1.34, 95% CI =1.03–1.74, P=0.03). The number of studies about C465T polymorphism was too small to pool the data. Conclusion There are increased risks of ALL in all subjects and of AML in Asians for carriers of the NQO1 C609T polymorphism. Further studies are needed to verify the associations of the C465T polymorphism with the risk of AL.
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Affiliation(s)
| | - Xiaoyu Zhai
- Clinical Research Center; College of Pharmacy, Xi'an Medical University
| | | | | | - Yajing Zhai
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University
| | | | - Yonghua Chen
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
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Amitay EL, Dubnov Raz G, Keinan-Boker L. Breastfeeding, Other Early Life Exposures and Childhood Leukemia and Lymphoma. Nutr Cancer 2016; 68:968-77. [PMID: 27352124 DOI: 10.1080/01635581.2016.1190020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Childhood cancer incidence increases and although rare, it is a leading cause of mortality. Leukemia and lymphoma comprise 40% of all cancers in children but little is known of their etiology. In this study, we examined the associations of breastfeeding and other early life exposures with childhood leukemia and lymphoma. A population-based case-control study carried out in 2011-2013 comprised mothers of 190 incidents (2005-2013) of leukemia/lymphoma cases aged 1-19 yr at diagnosis and 384 population-based controls. Interviews based on a computerized structured questionnaire were conducted with the mothers. Multivariate logistic regression models adjusted for potential confounders assessed the association between breastfeeding patterns and childhood leukemia/lymphoma. Ever breastfeeding category was associated with a 64% decreased risk for childhood leukemia/lymphoma lsqb;odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.22, 0.60lrqb; and similar trends, with a dose-response effect, were observed for any breastfeeding (exclusive and/or partial) category for 6, 12, and 18+ mo. Other infant exposures associated with cancer risk were child iron supplementation (OR = 0.39, 95% CI: 0.26, 0.59), pet ownership (OR = 0.50, 95% CI: 0.33, 0.78), paternal smoking (OR = 1.93, 95% CI: 1.18, 3.15), and having older siblings (OR = 1.18, 95% CI: 1.05, 1.33). Breastfeeding-a controllable and modifiable exposure-is inversely associated with risk for childhood leukemia and lymphoma with a dose-response effect.
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Affiliation(s)
- Efrat Lev Amitay
- a School of Public Health , University of Haifa , Haifa , Israel
| | - Gal Dubnov Raz
- b Exercise, Lifestyle and Nutrition Clinic , The Edmond and Lily Safra Children's Hospital, Sheba Medical Center , Ramat Gan , Israel.,c Israel Center for Disease Control , Ministry of Health , Ramat Gan , Israel
| | - Lital Keinan-Boker
- c Israel Center for Disease Control , Ministry of Health , Ramat Gan , Israel.,d School of Public Health , Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa , Israel
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10
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Yan K, Xu X, Liu X, Wang X, Hua S, Wang C, Liu X. Corrigendum: The Associations Between Maternal Factors During Pregnancy and the Risk of Childhood Acute Lymphoblastic Leukemia: A Meta-Analysis. Pediatr Blood Cancer 2016; 63:953-4. [PMID: 26999072 DOI: 10.1002/pbc.25962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/02/2016] [Indexed: 12/27/2022]
Abstract
Because of the erroneous application of multiple publications, the conclusions of our recent paper (Pediatr Blood Cancer 2015;62:1162-70) were not reliable. The corrected results show that coffee drinking during pregnancy was risk factor for childhood acute lymphoblastic leukemia (OR = 1.44, 95% confidence interval = 1.07-1.92).
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Affiliation(s)
- Kangkang Yan
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuejing Xu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaodong Liu
- Key Laboratory of Radiobiology (Ministry of Health), School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xikui Wang
- Department of Statistics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shucheng Hua
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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11
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Bailey HD, Armstrong BK, Milne E, Schüz J, Clavel J. Comment on: The Associations Between Maternal Factors During Pregnancy and the Risk of Childhood Acute Lymphoblastic Leukemia: A Meta-Analysis. Pediatr Blood Cancer 2016; 63:951-2. [PMID: 26945804 DOI: 10.1002/pbc.25717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/02/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Helen D Bailey
- Institut National de la Santé (INSERM) U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
| | - Bruce K Armstrong
- Sydney School of Public Health, University of Sydney, New South Wales, Australia
- Sax Institute, Ultimo, New South Wales, Australia
| | - Elizabeth Milne
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
| | - Jacqueline Clavel
- Institut National de la Santé (INSERM) U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Villejuif, France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
- RNCE-National Registry of Childhood Cancers, Villejuif, France
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12
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Momen NC, Olsen J, Gissler M, Li J. Exposure to maternal smoking during pregnancy and risk of childhood cancer: a study using the Danish national registers. Cancer Causes Control 2015; 27:341-9. [PMID: 26689564 DOI: 10.1007/s10552-015-0707-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/10/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE The relation between maternal smoking during pregnancy and childhood cancer in the offspring remains uncertain. This paper uses Danish national registers, which have collected data prospectively on smoking and cancer, to investigate the association. METHODS Smoking during pregnancy was ascertained from maternal self-reported data in the Danish National Patient Register. Index children were followed up from birth until the first of the following events: cancer diagnosis, death, emigration, day before 15th birthday, or end of follow-up. Smoking during pregnancy was considered as a binary variable (no smoking in pregnancy and smoking in pregnancy) and by amounts smoked (no smoking, cessation during pregnancy, ≤5, 6-10, or ≥11 cigarettes/day). RESULTS Of the 801,867 children included in the study, 20 % were exposed to maternal smoking during pregnancy. Overall, the hazard ratio (HR) for childhood cancer for the exposed compared to the non-exposed was 0.91 [95 % confidence interval (CI) 0.78, 1.07]. Stratification by number of cigarettes also gave statistically nonsignificant inverse associations. There was a statistically significant increased risk of childhood cancer among children whose mothers reported smoking cessation in pregnancy (HR 1.46; 95 % CI 1.01, 2.10). Regarding specific cancer sites, maternal smoking in pregnancy was positively associated with the risk of eye cancers in childhood. CONCLUSIONS Our results do not provide evidence for an association between maternal smoking in pregnancy and childhood cancer overall. An increased risk of childhood cancer was seen for children whose mothers reported smoking cessation in pregnancy. Future research could employ biomarkers, such as cotinine, to validate maternal smoking status recorded in registers as, even if collected prospectively, this self-reported variable may be subject to reporting bias.
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Affiliation(s)
- Natalie C Momen
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus C, Denmark.
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus C, Denmark.,Department of Epidemiology, University of California, Los Angeles, CA, USA.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Mika Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland.,Nordic School of Public Health NHV, Göthenburg, Sweden
| | - Jiong Li
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus C, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
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13
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Lu J, Zhao Q, Zhai YJ, He HR, Yang LH, Gao F, Zhou RS, Zheng J, Ma XC. Genetic polymorphisms of CYP1A1 and risk of leukemia: a meta-analysis. Onco Targets Ther 2015; 8:2883-902. [PMID: 26491362 PMCID: PMC4608596 DOI: 10.2147/ott.s92259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The associations between CYP1A1 polymorphisms and risk of leukemia have been studied extensively, but the results have been inconsistent. Therefore, in this study, we performed a meta-analysis to clarify associations of three CYP1A1 polymorphisms (T3801C, A2455G, and C4887A) with the risks of acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML). Medline, EMBASE, and China National Knowledge Infrastructure databases were searched to collect relevant studies published up to April 20, 2015. The extracted data were analyzed statistically, and pooled odds ratios with 95% confidence intervals were calculated to quantify the associations. Overall, 26 publications were included. Finally, T3801C was associated with an increased risk of AML in Asians under the dominant model. For A2455G, the risk of ALL was increased among Caucasians in the recessive model and the allele-contrast model; A2455G was also associated with an increased risk of CML among Caucasians under the recessive model, dominant model, and allele-contrast model. For C4887A, few of the included studies produced data. In conclusion, the results suggest that Asians carrying the T3801C C allele might have an increased risk of AML and that Caucasians with the A2455G GG genotype might have an increased risk of ALL. Further investigations are needed to confirm these associations.
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Affiliation(s)
- Jun Lu
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Qian Zhao
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China ; College of Pharmacy, Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Ya-Jing Zhai
- Department of Pharmacy, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Hai-Rong He
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Li-Hong Yang
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Fan Gao
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Rong-Sheng Zhou
- Department of Anesthesiology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Jie Zheng
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Xian-Cang Ma
- Clinical Research Center, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China ; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
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14
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Carvalho DC, Wanderley AV, Amador MAT, Fernandes MR, Cavalcante GC, Pantoja KBCC, Mello FAR, de Assumpção PP, Khayat AS, Ribeiro-Dos-Santos Â, Santos S, Dos Santos NPC. Amerindian genetic ancestry and INDEL polymorphisms associated with susceptibility of childhood B-cell Leukemia in an admixed population from the Brazilian Amazon. Leuk Res 2015; 39:S0145-2126(15)30361-1. [PMID: 26321572 DOI: 10.1016/j.leukres.2015.08.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 07/14/2015] [Accepted: 08/15/2015] [Indexed: 12/29/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is a malignant tumor common in children. Studies of genetic susceptibility to cancer using biallelic insertion/deletion (INDEL) type polymorphisms associated with cancer development pathways may help to clarify etymology of ALL. In this study, we investigate the role of eight functional INDEL polymorphisms and influence of genetic ancestry to B-cell ALL susceptibility in children of Brazilian Amazon population, which has a high degree of inter-ethnic admixture. Ancestry analysis was estimated using a panel of 48 autosomal ancestry informative markers. 130 B-cell ALL patients and 125 healthy controls were included in this study. The odds ratios and 95% confidence intervals were adjusted for confounders. The results indicated an association between the investigated INDEL polymorphisms in CASP8 (rs3834129), CYP19A1 (rs11575899) e XRCC1 (rs3213239) genes in the development of B-cell ALL. The carriers of Insertion/Insertion (Ins/Ins) genotype of the polymorphism in CASP8 gene presented reduced chances of developing B-cell ALL (P=0.001; OR=0.353; 95% CI=0.192-0.651). The Deletion/Deletion (Del/Del) genotype of the polymorphism in CYP19A1 gene was associated to a lower chance of developing B-cell ALL (P=3.35×10-6; OR=0.121; 95% CI=0.050-0.295), while Del/Del genotype of the polymorphism in XRCC1 gene was associated to a higher chance of developing B-cell ALL (P=2.01×10-4; OR=6.559; 95% CI=2.433-17.681). We also found that Amerindian ancestry correlates with the risk of B-cell ALL. For each increase of 10% in the Amerindian ancestry results in 1.4-fold chances of developing B-cell ALL (OR=1.406; 95% IC=1.123-1.761), while each increase of 10% in the European ancestry presents a protection effect in the development of B-cell ALL (OR=0.666; 95% IC=0.536-0.827). The results suggest that genetic factors influence leukemogenesis and might be explored in the stratification of B-cell ALL risk in admixed populations.
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Affiliation(s)
- Darlen C Carvalho
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Alayde V Wanderley
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Hospital Ophir Loyola, Departamento de Pediatria, Belém, Pará, PA, Brazil.
| | - Marcos A T Amador
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Marianne R Fernandes
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Giovanna C Cavalcante
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Karla B C C Pantoja
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Fernando A R Mello
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil.
| | - Paulo P de Assumpção
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, PA, Brazil.
| | - André S Khayat
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil.
| | - Ândrea Ribeiro-Dos-Santos
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Sidney Santos
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
| | - Ney P C Dos Santos
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, PA, Brazil; Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Belém, Pará, PA, Brazil.
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15
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Yan K, Xu X, Liu X, Wang X, Hua S, Wang C, Liu X. The associations between maternal factors during pregnancy and the risk of childhood acute lymphoblastic leukemia: A meta-analysis. Pediatr Blood Cancer 2015; 62:1162-70. [PMID: 25728190 DOI: 10.1002/pbc.25443] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/26/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although genetic and environmental factors are considered to be the main causes of acute lymphoblastic leukemia, the associations between maternal factors during pregnancy and the childhood ALL is still unclear. PROCEDURE In this study, meta-analysis was used. Medline, PubMed, and Web of Science were searched. The result was assessed based on pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS The pooled ORs showed that there were associations between childhood ALL and the birth order (The first vs others, OR = 1.08, 95%CI = 1.00-1.16), the education of pregnant woman (>high school vs ≤ high school, OR = 0.82, 95%CI = 0.77-0.86), smoking (Ever vs never, OR = 1.10, 95%CI = 1.02-1.19). CONCLUSIONS Our meta-analysis showed that there were important associations between childhood ALL and the birth order, the education of pregnant woman, smoking.
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Affiliation(s)
- Kangkang Yan
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuejing Xu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaodong Liu
- Key Laboratory of Radiobiology (Ministry of Health), School of Public Health, Jilin University, Changchun, China
| | - Xikui Wang
- Department of Statistics, University of Manitoba, Winnipeg, Canada
| | - Shucheng Hua
- The First Hospital of Jilin University, Changchun, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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16
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Brisson GD, Alves LR, Pombo-de-Oliveira MS. Genetic susceptibility in childhood acute leukaemias: a systematic review. Ecancermedicalscience 2015; 9:539. [PMID: 26045716 PMCID: PMC4448992 DOI: 10.3332/ecancer.2015.539] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Indexed: 11/06/2022] Open
Abstract
Acute leukaemias (AL) correspond to 25-35% of all cancer cases in children. The aetiology is still sheltered, although several factors are implicated in causality of AL subtypes. Childhood acute leukaemias are associated with genetic syndromes (5%) and ionising radiation as risk factors. Somatic genomic alterations occur during fetal life and are initiating events to childhood leukaemia. Genetic susceptibility has been explored as a risk factor, since environmental exposure of the child to xenobiotics, direct or indirectly, can contribute to the accumulation of somatic mutations. Hence, a systematic review was conducted in order to understand the association between gene polymorphisms and childhood leukaemia risk. The search was performed in the electronic databases PubMed, Lilacs, and Scielo, selecting articles published between 1995 and 2013. This review included 90 case-control publications, which were classified into four groups: xenobiotic system (n = 50), DNA repair (n = 16), regulatory genes (n = 15), and genome wide association studies (GWAS) (n = 9). We observed that the most frequently investigated genes were: NQO1, GSTM1, GSTT1, GSTP1, CYP1A1, NAT2, CYP2D6, CYP2E1, MDR1 (ABCB1), XRCC1, ARID5B, and IKZF1. The collected evidence suggests that genetic polymorphisms in CYP2E1, GSTM1, NQO1, NAT2, MDR1, and XRCC1 are capable of modulating leukaemia risk, mainly when associated with environmental exposures, such as domestic pesticides and insecticides, smoking, trihalomethanes, alcohol consumption, and x-rays. More recently, genome wide association studies identified significant associations between genetic polymorphisms in ARID5B e IKZF1 and acute lymphoblastic leukaemia, but only a few studies have replicated these results until now. In conclusion, genetic susceptibility contributes to the risk of childhood leukaemia through the effects of gene-gene and gene-environment interactions.
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Affiliation(s)
- Gisele D Brisson
- Paediatric Haematology-Oncology Programme, Research Centre, Instituto Nacional de Câncer, Rio de Janeiro, Brazil, 20231050
| | - Liliane R Alves
- Pharmacy Service, Multiprofessional Residency Programme, Instituto Nacional de Câncer, Rio de Janeiro, Brazil, 20231050
| | - Maria S Pombo-de-Oliveira
- Paediatric Haematology-Oncology Programme, Research Centre, Instituto Nacional de Câncer, Rio de Janeiro, Brazil, 20231050
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17
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Kamel AM, Ebid GTA, Moussa HS. N-Acetyltransferase 2 (NAT2) polymorphism as a risk modifier of susceptibility to pediatric acute lymphoblastic leukemia. Tumour Biol 2015; 36:6341-8. [PMID: 25804798 DOI: 10.1007/s13277-015-3320-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/12/2015] [Indexed: 12/18/2022] Open
Abstract
N-Acetyltransferases (NAT) have been known to modify the risk to a variety of solid tumors. However, the role of NAT2 polymorphism in risk susceptibility to childhood acute lymphoblastic leukemia (ALL) is still not well known. We performed a case-control study to determine if the common NAT2 polymorphisms play a role in altering susceptibility to pediatric ALL. DNA of 92 pediatric ALL patients and 312 healthy controls was analyzed for the NAT2 polymorphisms using the PCR-RFLP method. The wild-type NAT2*4 was encountered in 8.6 % of patients versus 11.8 % of controls (P = 0.23). The rapid acetylators NAT2*12 803A>G, AG, GG, and AG/GG were overrepresented in controls (P = 0.0001; odds ratio (OR) 0.22, 0.19, and 0.21 respectively). NAT2*5D 341T>C and NAT2*11A 481C>T were of comparable frequencies. For their combination, NAT2*5A, a slow acetylator, both TCTT and CCCT were overrepresented in patients (P < 0.001; OR 15.8 and 17.9 respectively). NAT2*5B (803A>G, 341T>C, 481C>T) was overrepresented in controls (P < 0.001; OR 0.12). Apparently, 803A>G ameliorated the combined effect of 341T>C and 481C>T. A similar effect was obtained with NAT2*5C (341T>A, 803A>G) (P < 0.0001; OR 0.11). For slow acetylator NAT2*7A 857G>A, GA and GA/AA were overrepresented in patients (P = 0.009 and 0.01; OR 2.74 and 2.72 respectively). NAT2*13 282C>T, NAT2*6B 590G>A, and NAT2*14A 191G>A were of comparable frequencies. NAT2 282C>A in combination with NAT2 857G>A (NAT2*7B) showed a synergistic effect in patients versus controls (P < 0.0001; OR 3.51). In conclusion, NAT2 gene polymorphism(s) with slow acetylator phenotype is generally associated with the risk of development of ALL in children.
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Affiliation(s)
- Azza M Kamel
- Clinical Pathology Department, NCI, Cairo University, Fom El-Khalig square, Kasr El-Aini St, Cairo, 11796, Egypt,
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Tang ZH, Zhang C, Cheng P, Sun HM, Jin Y, Chen YJ, Huang F. Glutathione-S-transferase polymorphisms (GSTM1, GSTT1 and GSTP1) and acute leukemia risk in Asians: a meta-analysis. Asian Pac J Cancer Prev 2014; 15:2075-81. [PMID: 24716937 DOI: 10.7314/apjcp.2014.15.5.2075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The association between glutathione-S-transferase polymorphisms (GSTM1, GSTT1 and GSTP1) and risk of acute leukemia in Asians remains controversial. This study was therefore designed to evaluate the precise association in 23 studies identified by a search of PubMed and several other databases, up to December 2013. Using random or fixed effects models odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Heterogeneity across studies was assessed, and funnel plots were constructed to test for publication bias. The meta-analysis showed positive associations between GST polymorphisms (GSTM1 and GSTT1 but not GSTP1) and acute leukemia risk [(OR=1.47, 95% CI 1.18-1.83); (OR=1.32, 95% CI 1.07-1.62); (OR=1.01, 95% CI 0.84-1.23), respectively] and heterogeneity between the studies. The results suggested that the GSTM1 null genotype and GSTT1null genotype, but not the GSTP1 polymorphism, might be a potential risk factors for acute leukemia. Further well-designed studies are needed to confirm our findings.
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Affiliation(s)
- Zhen-Hai Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China E-mail :
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Yang X, Wang Y, Wang G. Quantitative assessment of the influence of EPHX1 gene polymorphisms and cancer risk: a meta-analysis with 94,213 subjects. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2014; 33:82. [PMID: 25261893 PMCID: PMC4189664 DOI: 10.1186/s13046-014-0082-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/22/2014] [Indexed: 12/13/2022]
Abstract
Purpose Previous studies investigating the association between EPHX1 polymorphisms (Tyr113His and His139Arg) and cancer risk have yielded inconsistent results. This meta-analysis was performed to derive a more precise estimation of relationship between two EPHX1 polymorphisms and risk of different types of cancer. Methods Data were extracted from relevant studies detected by a systematic literature search. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of the association between EPHX1 polymorphisms and cancer risk. Results This meta-analysis carefully collected 99 studies on these two polymorphisms and cancer risk published up to March 2014, consisting of 45 studies (20,091 cases and 27,396 controls) for Tyr113His and 54 studies (19,437 cases and 27,289 controls) for His139Arg. The results in overall population did not show any significant association between these two polymorphisms and cancer risk for all genetic models. However, EPHX1 Tyr113His homozygote individuals have a significantly increased risk of cancer among Asians (homozygote model: OR =1.46, 95% CI=1.05–2.03; recessive model: OR =1.39, 95% CI =1.10–1.76) and mixed population (homozygote model: OR =1.17, 95% CI =1.02–1.34; recessive model: OR =1.17, 95% CI =1.02–1.33), but not Caucasians. Conclusion His/His genotype of EPHX1 Tyr113His polymorphism is a risk factor for developing caner for Asian and mixed population, while no evidence was found for the association between the EPHX1 His139Arg polymorphism and increased cancer risk. Electronic supplementary material The online version of this article (doi:10.1186/s13046-014-0082-9) contains supplementary material, which is available to authorized users.
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Pharmacogenomic characterization of gemcitabine response--a framework for data integration to enable personalized medicine. Pharmacogenet Genomics 2014; 24:81-93. [PMID: 24401833 PMCID: PMC3888473 DOI: 10.1097/fpc.0000000000000015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Supplemental Digital Content is available in the text. Objectives Response to the oncology drug gemcitabine may be variable in part due to genetic differences in the enzymes and transporters responsible for its metabolism and disposition. The aim of our in-silico study was to identify gene variants significantly associated with gemcitabine response that may help to personalize treatment in the clinic. Methods We analyzed two independent data sets: (a) genotype data from NCI-60 cell lines using the Affymetrix DMET 1.0 platform combined with gemcitabine cytotoxicity data in those cell lines, and (b) genome-wide association studies (GWAS) data from 351 pancreatic cancer patients treated on an NCI-sponsored phase III clinical trial. We also performed a subset analysis on the GWAS data set for 135 patients who were given gemcitabine+placebo. Statistical and systems biology analyses were performed on each individual data set to identify biomarkers significantly associated with gemcitabine response. Results Genetic variants in the ABC transporters (ABCC1, ABCC4) and the CYP4 family members CYP4F8 and CYP4F12, CHST3, and PPARD were found to be significant in both the NCI-60 and GWAS data sets. We report significant association between drug response and variants within members of the chondroitin sulfotransferase family (CHST) whose role in gemcitabine response is yet to be delineated. Conclusion Biomarkers identified in this integrative analysis may contribute insights into gemcitabine response variability. As genotype data become more readily available, similar studies can be conducted to gain insights into drug response mechanisms and to facilitate clinical trial design and regulatory reviews.
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Direct sequencing and comprehensive screening of genetic polymorphisms on CYP2 family genes (CYP2A6, CYP2B6, CYP2C8, and CYP2E1) in five ethnic populations. Arch Pharm Res 2014; 38:115-28. [DOI: 10.1007/s12272-014-0348-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/27/2014] [Indexed: 01/11/2023]
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22
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Association between the CYP1A1 T3801C polymorphism and risk of cancer: Evidence from 268 case–control studies. Gene 2014. [DOI: 10.1016/j.gene.2013.10.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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23
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Metayer C, Zhang L, Wiemels JL, Bartley K, Schiffman J, Ma X, Aldrich MC, Chang JS, Selvin S, Fu CH, Ducore J, Smith MT, Buffler PA. Tobacco smoke exposure and the risk of childhood acute lymphoblastic and myeloid leukemias by cytogenetic subtype. Cancer Epidemiol Biomarkers Prev 2013; 22:1600-11. [PMID: 23853208 PMCID: PMC3769478 DOI: 10.1158/1055-9965.epi-13-0350] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tobacco smoke contains carcinogens known to damage somatic and germ cells. We investigated the effect of tobacco smoke on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML), especially subtypes of prenatal origin such as ALL with translocation t(12;21) or high-hyperdiploidy (51-67 chromosomes). METHODS We collected information on exposures to tobacco smoking before conception, during pregnancy, and after birth in 767 ALL cases, 135 AML cases, and 1,139 controls (1996-2008). Among cases, chromosome translocations, deletions, or aneuploidy were identified by conventional karyotype and fluorescence in situ hybridization. RESULTS Multivariable regression analyses for ALL and AML overall showed no definite evidence of associations with self-reported (yes/no) parental prenatal active smoking and child's passive smoking. However, children with history of paternal prenatal smoking combined with postnatal passive smoking had a 1.5-fold increased risk of ALL [95% confidence interval (CI), 1.01-2.23], compared to those without smoking history (ORs for pre- or postnatal smoking only were close to one). This joint effect was seen for B-cell precursor ALL with t(12;21) (OR = 2.08; 95% CI, 1.04-4.16), but not high hyperdiploid B-cell ALL. Similarly, child's passive smoking was associated with an elevated risk of AML with chromosome structural changes (OR = 2.76; 95% CI, 1.01-7.58), but not aneuploidy. CONCLUSIONS Our data suggest that exposure to tobacco smoking was associated with increased risks of childhood ALL and AML; and risks varied by timing of exposure (before and/or after birth) and cytogenetic subtype, based on imprecise estimates. IMPACT Parents should limit exposures to tobacco smoke before and after the child's birth.
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Affiliation(s)
- Catherine Metayer
- School of Public Health, University of California, 1995 University Avenue, Suite 460, Berkeley, CA94704-7392, USA.
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Bonaventure A, Rudant J, Goujon-Bellec S, Orsi L, Leverger G, Baruchel A, Bertrand Y, Nelken B, Pasquet M, Michel G, Sirvent N, Bordigoni P, Ducassou S, Rialland X, Zelenika D, Hémon D, Clavel J. Childhood acute leukemia, maternal beverage intake during pregnancy, and metabolic polymorphisms. Cancer Causes Control 2013; 24:783-93. [DOI: 10.1007/s10552-013-0161-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 01/23/2013] [Indexed: 11/24/2022]
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25
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Metayer C, Milne E, Clavel J, Infante-Rivard C, Petridou E, Taylor M, Schüz J, Spector LG, Dockerty JD, Magnani C, Pombo-de-Oliveira MS, Sinnett D, Murphy M, Roman E, Monge P, Ezzat S, Mueller BA, Scheurer ME, Armstrong BK, Birch J, Kaatsch P, Koifman S, Lightfoot T, Bhatti P, Bondy ML, Rudant J, O'Neill K, Miligi L, Dessypris N, Kang AY, Buffler PA. The Childhood Leukemia International Consortium. Cancer Epidemiol 2013; 37:336-47. [PMID: 23403126 DOI: 10.1016/j.canep.2012.12.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/17/2012] [Accepted: 12/29/2012] [Indexed: 02/05/2023]
Abstract
BACKGROUND Acute leukemia is the most common cancer in children under 15 years of age; 80% are acute lymphoblastic leukemia (ALL) and 17% are acute myeloid leukemia (AML). Childhood leukemia shows further diversity based on cytogenetic and molecular characteristics, which may relate to distinct etiologies. Case-control studies conducted worldwide, particularly of ALL, have collected a wealth of data on potential risk factors and in some studies, biospecimens. There is growing evidence for the role of infectious/immunologic factors, fetal growth, and several environmental factors in the etiology of childhood ALL. The risk of childhood leukemia, like other complex diseases, is likely to be influenced both by independent and interactive effects of genes and environmental exposures. While some studies have analyzed the role of genetic variants, few have been sufficiently powered to investigate gene-environment interactions. OBJECTIVES The Childhood Leukemia International Consortium (CLIC) was established in 2007 to promote investigations of rarer exposures, gene-environment interactions and subtype-specific associations through the pooling of data from independent studies. METHODS By September 2012, CLIC included 22 studies (recruitment period: 1962-present) from 12 countries, totaling approximately 31000 cases and 50000 controls. Of these, 19 case-control studies have collected detailed epidemiologic data, and DNA samples have been collected from children and child-parent trios in 15 and 13 of these studies, respectively. Two registry-based studies and one study comprising hospital records routinely obtained at birth and/or diagnosis have limited interview data or biospecimens. CONCLUSIONS CLIC provides a unique opportunity to fill gaps in knowledge about the role of environmental and genetic risk factors, critical windows of exposure, the effects of gene-environment interactions and associations among specific leukemia subtypes in different ethnic groups.
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Affiliation(s)
- Catherine Metayer
- University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 460, Berkeley, CA 94704-1070, USA.
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Current evidence for an inherited genetic basis of childhood acute lymphoblastic leukemia. Int J Hematol 2012; 97:3-19. [DOI: 10.1007/s12185-012-1220-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 10/31/2012] [Indexed: 11/30/2022]
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Does cytochrome P450 1A1 MspI polymorphism increase acute lymphoblastic leukemia risk? Evidence from 2013 cases and 2903 controls. Gene 2012; 510:14-21. [DOI: 10.1016/j.gene.2012.08.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 08/20/2012] [Accepted: 08/25/2012] [Indexed: 12/11/2022]
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Vinceti M, Rothman KJ, Crespi CM, Sterni A, Cherubini A, Guerra L, Maffeis G, Ferretti E, Fabbi S, Teggi S, Consonni D, De Girolamo G, Meggiato A, Palazzi G, Paolucci P, Malagoli C. Leukemia risk in children exposed to benzene and PM10 from vehicular traffic: a case-control study in an Italian population. Eur J Epidemiol 2012; 27:781-90. [PMID: 22892901 PMCID: PMC3493667 DOI: 10.1007/s10654-012-9727-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 07/28/2012] [Indexed: 02/06/2023]
Abstract
Benzene, a recognized occupational leukemogen in adults, has been hypothesized to also increase the risk of childhood leukemia. We carried out a population-based case–control study in a northern Italy community involving 83 cases with acute childhood leukemia diagnosed in the years 1998–2009 and 332 matched controls. We assessed residential exposure to benzene and to particulate matter ≤10 μm (PM10) from motorized traffic using geocoded residences and detailed emission and dispersion modeling. Exposure to benzene, and to a lesser extent to PM10, appeared to be independently associated with an excess leukemia risk. When we stratified the study population by age and by leukemia subtype, the relative risk associated with benzene exposure was higher among children aged less than 5 years, and despite small numbers this relation appeared to be considerably stronger for acute myeloid leukemia than for acute lymphoblastic leukemia. Overall, these findings suggest that exposure to low levels of benzene released from motorized traffic may increase the risk of childhood leukemia, and suggest a possible independent effect of PM10, although unmeasured confounding due to other pollutants cannot be ruled out.
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Affiliation(s)
- Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Public Health Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Zhuo W, Zhang L, Wang Y, Zhu B, Chen Z. CYP1A1 MspI polymorphism and acute myeloid leukemia risk: meta-analyses based on 5018 subjects. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2012; 31:62. [PMID: 22846179 PMCID: PMC3444413 DOI: 10.1186/1756-9966-31-62] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 07/13/2012] [Indexed: 12/11/2022]
Abstract
Background Evidence indicates that CYP1A1 MspI polymorphism might be a possible risk factor for several malignancies. A growing body of literature has been devoted to the association of CYP1A1 MspI polymorphism with acute myeloid leukemia (AML). However, the results remain conflicting. The aim of the present study was to derive a more precise estimation of the relationship. Methods Meta-analyses assessing the association of CYP1A1 MspI variation with AML were conducted and subgroup analyses on ethnicity and age groups were further performed. Eligible studies were identified for the period up to May 2012. Results A total of ten case–control studies including 1330 cases and 3688 controls were selected for analysis. The overall data failed to indicate a significant association of CYP1A1 MspI polymorphism with AML risk (C vs T: OR = 1.13; 95%CI = 0.87-1.48; CC vs TT: OR = 1.72; 95%CI = 0.99-3.01; CC + TC vs TT: OR = 1.16; 95%CI = 0.86-1.55). In subgroup analysis stratified by ethnicity, significant AML risk was shown among Asians (CC + TC vs TT: OR = 1.33; 95%CI = 1.09-1.62) but not Caucasians or mixed races. In subgroup analysis regarding age groups, no associations were observed in either the childhood AML or the adult AML subgroups. Conclusion The results of the present study suggested that CYP1A1 MspI polymorphism might be a risk factor for AML among Asians. Further investigations are needed to confirm the conclusions.
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Affiliation(s)
- Wenlei Zhuo
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
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Zhuo W, Zhang L, Ling J, Zhu B, Chen Z. MDM2 SNP309 variation contributes to leukemia risk: meta-analyses based on 7259 subjects. Leuk Lymphoma 2012; 53:2245-52. [PMID: 22563815 DOI: 10.3109/10428194.2012.691485] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Evidence implicates MDM2 (murine double minute-2) T309G polymorphism as a risk factor for several cancers. Increasing numbers of studies have been carried out on the association of MDM2 T309G polymorphism with susceptibility to leukemia and have generated conflicting results. The aim of the present study was to derive a more precise estimation of the relationship. Meta-analyses assessing the association of MDM2 T309G variation with leukemia were conducted. Separate analyses on ethnicity and clinical types were also performed. Eligible studies were identified for the period up to February 2012. Consequently, seven publications including eight case-control studies with 1777 cases and 5482 controls were selected for analysis. The overall data indicated a significant association of the MDM2 T309G polymorphism with leukemia risk (GG vs. TT: odds ratio [OR] = 1.62; 95% confidence interval [CI] = 1.14-2.29; dominant model: OR = 1.20; 95% CI = 1.06-1.36; recessive model: OR = 1.47; 95% CI = 1.07-2.03). In subgroup analysis by ethnicity, the G allele may increase leukemia susceptibility among Asians (GG vs. TT: OR = 3.06; 95% CI = 2.05-4.56; dominant model: OR = 1.82; 95% CI = 1.31-2.51; recessive model: OR = 2.32; 95% CI = 1.69-3.19) but not Caucasians. In subgroup analysis by clinical types, data suggested increased risk for acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) under additive and recessive models, respectively. Similarly, elevated risk for chronic lymphocytic leukemia (CLL) was shown under the dominant model. Collectively, the results of the present study suggest that MDM2 T309G polymorphism might be a low-penetrant risk factor for leukemia among Asians but not Caucasians. The G allele might increase CLL susceptibility and homozygous GG might elevate AML and CML risk.
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Affiliation(s)
- Wenlei Zhuo
- Th ird Military Medical University, Chongqing, China.
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