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Megías-Vericat JE, Montesinos P, Herrero MJ, Moscardó F, Bosó V, Rojas L, Martínez-Cuadrón D, Rodríguez-Veiga R, Sendra L, Cervera J, Poveda JL, Sanz MÁ, Aliño SF. Impact of NADPH oxidase functional polymorphisms in acute myeloid leukemia induction chemotherapy. Pharmacogenomics J 2018; 18:301-307. [PMID: 28485375 DOI: 10.1038/tpj.2017.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/22/2016] [Accepted: 01/09/2017] [Indexed: 02/04/2023]
Abstract
Efficacy and toxicity of anthracycline treatment in acute myeloid leukemia (AML) is mediated by reactive oxygen species (ROS). NADPH oxidase is the major endogenous source of ROS and a key mediator of oxidative cardiac damage. The impact of NADPH oxidase polymorphisms (CYBA:rs4673, NCF4:rs1883112, RAC2:rs13058338) was evaluated in 225 adult de novo AML patients. Variant alleles of NCF4 and RAC2 were related to higher complete remission (P=0.035, P=0.016), and CYBA homozygous variant showed lower overall survival with recessive model (P=0.045). Anthracycline-induced cardiotoxicity was associated to NCF4 homozygous variant (P=0.012) and CYBA heterozygous genotype (P=0.027). Novel associations were found between variant allele of CYBA and lower lung and gastrointestinal toxicities, and a protective effect in nephrotoxicity and RAC2 homozygous variant. Moreover, RAC2 homozygous variant was related to delayed thrombocytopenia recovery. This study supports the interest of NADPH oxidase polymorphisms regarding efficacy and toxicity of AML induction therapy, in a coherent integrated manner.
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Affiliation(s)
- J E Megías-Vericat
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - P Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M J Herrero
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Facultad de Medicina, Departamento Farmacología, Universidad de Valencia, Valencia, Spain
| | - F Moscardó
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - V Bosó
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Rojas
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Faculty of Medicine, Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - D Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - R Rodríguez-Veiga
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Sendra
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Facultad de Medicina, Departamento Farmacología, Universidad de Valencia, Valencia, Spain
| | - J Cervera
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - J L Poveda
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Á Sanz
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S F Aliño
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Facultad de Medicina, Departamento Farmacología, Universidad de Valencia, Valencia, Spain
- Unidad de Farmacología Clínica, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Megías Vericat JE, Montesinos P, Herrero MJ, Bosó V, Moscardó F, Rojas L, Martínez-Cuadrón D, Aliño SF, Sanz MA, Poveda JL. PKP-020 Impact of nadph oxidase functional polymorphisms in acute myeloid leukaemia induction chemotherapy. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Montesinos P, Rodríguez-Veiga R, Boluda B, Martínez-Cuadrón D, Cano I, Lancharro A, Sanz J, Arilla MJ, López-Chuliá F, Navarro I, Lorenzo I, Salavert M, Pemán J, Calvillo P, Martínez J, Carpio N, Jarque I, Sanz GF, Sanz MA. Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis. Bone Marrow Transplant 2015; 50:1465-72. [PMID: 26281032 DOI: 10.1038/bmt.2015.181] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 01/24/2023]
Abstract
Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to construct a post-engraftment IFD risk score. The 1-year CI of IFD was 11%. The non-relapse mortality was 40% in those developing IFD and 16% in those who did not. The intent-to-treat analysis showed that 17% of patients abandoned the assigned prophylaxis. Age >40 years, ⩾1 previous SCT, pre-engraftment neutropenia >15 days, extensive chronic GVHD and CMV reactivation were independent risk factors. The post-engraftment IFD score stratified patients into low risk (0-1 factor, CI 0.7%), intermediate risk (2 factors, CI 9.9%) and high risk (3-5 factors, CI 24.7%) (P<0.0001). The antifungal prophylaxis strategy failed to prevent post-engraftment IFD in 11% of alloSCT. Our risk score could be useful to implement risk-adapted strategies using antifungal prophylaxis after engraftment.
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Affiliation(s)
- P Montesinos
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - R Rodríguez-Veiga
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - B Boluda
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - D Martínez-Cuadrón
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Cano
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - A Lancharro
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M J Arilla
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - F López-Chuliá
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Navarro
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Lorenzo
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M Salavert
- Department of Infectious Diseases, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Pemán
- Department of Microbiology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - P Calvillo
- Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Martínez
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - N Carpio
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Jarque
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - G F Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M A Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain.,Departament de Medicina, Universitat de València, Valencia, Spain
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Megías Vericat J, Montesinos P, Herrero M, Moscardó F, Bosó V, Martínez-Cuadrón D, Rojas L, Aliño S, Sanz M, Poveda J. PKP-005 Prognostic impact of novel gene polymorphisms in newly diagnosed acute myeloid leukaemia adults undergoing induction chemotherapy: Abstract PKP-005 Table 1. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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