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Mosquera Orgueira A, Antelo Rodríguez B, Alonso Vence N, Díaz Arias JÁ, Díaz Varela N, Pérez Encinas MM, Allegue Toscano C, Goiricelaya Seco EM, Carracedo Álvarez Á, Bello López JL. The association of germline variants with chronic lymphocytic leukemia outcome suggests the implication of novel genes and pathways in clinical evolution. BMC Cancer 2019; 19:515. [PMID: 31142279 PMCID: PMC6542042 DOI: 10.1186/s12885-019-5628-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 04/23/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic Lymphocytic Leukemia (CLL) is the most frequent lymphoproliferative disorder in western countries and is characterized by a remarkable clinical heterogeneity. During the last decade, multiple genomic studies have identified a myriad of somatic events driving CLL proliferation and aggressivity. Nevertheless, and despite the mounting evidence of inherited risk for CLL development, the existence of germline variants associated with clinical outcomes has not been addressed in depth. METHODS Exome sequencing data from control leukocytes of CLL patients involved in the International Cancer Genome Consortium (ICGC) was used for genotyping. Cox regression was used to detect variants associated with clinical outcomes. Gene and pathways level associations were also calculated. RESULTS Single nucleotide polymorphisms in PPP4R2 and MAP3K4 were associated with earlier treatment need. A gene-level analysis evidenced a significant association of RIPK3 with both treatment need and survival. Furthermore, germline variability in pathways such as apoptosis, cell-cycle, pentose phosphate, GNα13 and Nitric oxide was associated with overall survival. CONCLUSION Our results support the existence of inherited conditionants of CLL evolution and points towards genes and pathways that may results useful as biomarkers of disease outcome. More research is needed to validate these findings.
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Affiliation(s)
- Adrián Mosquera Orgueira
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain. .,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain. .,University of Santiago de Compostela, Santiago, Spain.
| | - Beatriz Antelo Rodríguez
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain.,University of Santiago de Compostela, Santiago, Spain
| | - Natalia Alonso Vence
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain
| | - José Ángel Díaz Arias
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain
| | - Nicolás Díaz Varela
- Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain
| | - Manuel Mateo Pérez Encinas
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,University of Santiago de Compostela, Santiago, Spain
| | | | | | - Ángel Carracedo Álvarez
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain.,Fundación Pública de Medicina Xenómica, A Coruña, Spain
| | - José Luis Bello López
- Clinical University Hospital of Santiago de Compostela, Service of Hematology and Hemotherapy, 1st floor, Avenida da Choupana s/n, Santiago de Compostela, 15706, Spain.,Division of Hematology, SERGAS, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago, Spain.,University of Santiago de Compostela, Santiago, Spain
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Sánchez Martín A, Cabrera Figueroa S, Cruz Guerrero R, Hurtado LP, Hurlé ADG, Carracedo Álvarez Á. Impact of pharmacogenetics on CNS side effects related to efavirenz. Pharmacogenomics 2013; 14:1167-78. [DOI: 10.2217/pgs.13.111] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: This article evaluates which genetic factors are involved in CNS toxicity related to long-term treatment with efavirenz (EFV) standard doses and their relationship with plasma concentrations. Patients & methods: A total of 119 HIV-positive patients, in which 1350 EFV plasma concentrations, 68 SNPs and 14 EFV-related adverse effects (AEs) were analyzed. Results: Overall, 32.77% of patients reported CNS toxicity and 8.40% had concentrations above the therapeutic range. A correlation was mainly found between patients with global CNS AEs and high EFV maximum steady-state plasma concentration (p = 1.47 × 10-6). A preliminary analysis confirmed that CYP2B6*6 (516G>T and 785A>G) was the most highly correlated (p = 0.005) with AEs and high plasma concentrations. In a second analysis adjusting for maximum steady-state plasma concentration, suggestive genetic associations were found between BCRP 421C>A, MRP1 816G>A, 5-HT2A 102C>T and different AEs. Conclusion: The finding of the involvement of these SNPs in EFV toxicity opens the door for further studies to confirm their validity and for their application in the future clinical practice. Original submitted 18 February 2013; Revision submitted 17 May 2013
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Affiliation(s)
| | | | - Raquel Cruz Guerrero
- Fundación Galega Medicina Xenómica y Centro de Investigación Biomédica en Red de Enfermedades Raras – USC– CIMUS – IDIS, Spain
| | - Liliana Porras Hurtado
- Fundación Galega Medicina Xenómica (SERGAS)-CeGen-University of Santiago de Compostela, Spain
- ESE Salud Pereira, Colombia
| | | | - Ángel Carracedo Álvarez
- Fundación Galega Medicina Xenómica (SERGAS)-CeGen-University of Santiago de Compostela, Spain
- USC – Centro de investigación biomédica en red de Enfermedades Raras, Spain
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