Genetic polymorphisms, susceptibility and treatment outcome in children with acute lymphoblastic leukemia / Polimorfismos genéticos, susceptibilidade e resposta ao tratamento em crianças portadoras de leucemia linfoblástica aguda

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

The leukemias are the most common type of cancer in children, representing above 30% of all the pediatric malignancies. Among them, the acute lymphoblastic leukemia (ALL) is the most frequent, with a percentage of 75% of the total pediatric cases of leukemia. Its occurrence is closely related to the exposure to chemical, physical and biological environmental factors and so maternal factors either, such as drugs, alcohol even in the uterine phase or after birth. Despite all the investigations made until now, little is known about the leucemogenous process, in particular about the importance of herdable genetic susceptibility and environmental factors. The citochrome P450 enzymes, as well as other phase I and II enzymes are involved on the biotransformation process of a huge variety of xenobiotics on food, smoke, alcohol, drugs and chemical poluents. Polymorphisms on these genes have been associated to the increased susceptibility to different kind of adult cancers and hematological diseases in adults and child. Similarly, the differential capacity of children with ALL to metabolize carcinogen compounds and chemotherapy drugs, witch is influenced by polymorphisms on genes that encode metabolizing enzymes, can modify the individual risk of relapse and therapy response. Thus, molecular epidemiological investigations in children with acute leukemia became so important to help clinicians answer questions about the etiology and the right mechanisms that induce this malignance and about the adverse responses to therapy found in huge number of patients, trying to reach more specific treatments. So, the present study objective is to evaluate the polymorphism frequency on the following genes CYP2D6, EPHX1 and MPO (xenobiotic metabolizing genes) and TS gene (DNA synthesis) in patients with ALL and in controls individuals. We analyzed 132 patients and 300 health controls by PCR-RFLP technique. The CYP2D6*3 variant was more frequent on the case group. The EPHX1*2 and the triple repeat (3R) of TS gene were more frequent on the control group. The heterozygous genotype for the TS gene and the homozygous for the MPO gene were more prevalent on the female group, suggesting an association of these polymorphisms with the gender. We did not find any association with the studied polymorphisms and the response to therapy. Beyond these data, is it possible to suggest an association of these polymorphisms and the leukemia development susceptibility, emphasizing the importance of the polymorphism determination for prognosis and for the prevention, related to the increased risk of the diseases related to environmental exposure.

ASSUNTO(S)

genetic polymorphisms pcr-rflp acute linfóide leukemia pcr-rflp polimorfismos genéticos leucemia linfóide aguda susceptibilidade susceptibilidade

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