Abstract | PURPOSE: EXPERIMENTAL DESIGN: We recently reported the results of an association study between ASNase pathway genes and event-free survival (EFS) in childhood patients with ALL. The same polymorphisms were interrogated here in relation to allergies, pancreatitis, and thrombotic events following treatment with E. coli ASNase. RESULTS: Among patients of the discovery group, allergies, and pancreatitis were more frequent in individuals who are homozygous for the triple-repeat allele (3R) of the asparagine synthetase (ASNS) gene, resulting in remarkably higher risk of these toxicities associated with 3R3R genotype [OR for allergies, 14.6; 95% confidence interval (CI), 3.6-58.7; P < 0.0005 and OR for pancreatitis, 8.6; 95% CI, 2.0-37.3; P = 0.01]. In contrast, the ASNS haplotype *1 harboring double-repeat (2R) allele had protective effect against these adverse reactions (P ≤ 0.01). The same haplotype was previously reported to confer reduction in EFS. The risk effect of 3R3R genotype was not replicated in the validation cohort, whereas the protective effect of haplotype *1 against allergies was maintained (P ≤ 0.002). Analysis with additional polymorphisms in ASNS locus in lymphoblastoid cell lines showed that haplotype *1 is diversified in several subtypes of which one was associated with reduced in vitro sensitivity to ASNase (rs10486009, P = 0.01) possibly explaining an association seen in clinical setting. CONCLUSIONS: This finding might have implication for treatment individualization in ALL and other cancers using asparagine depletion strategies. Clin Cancer Res; 21(2); 329-34. ©2014 AACR. See related commentary by Avramis, p. 230.
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Authors | Mohsen Ben Tanfous, Bahram Sharif-Askari, Francesco Ceppi, Haithem Laaribi, Vincent Gagné, Julie Rousseau, Malgorzata Labuda, Lewis B Silverman, Stephen E Sallan, Donna Neuberg, Jeffery L Kutok, Daniel Sinnett, Caroline Laverdière, Maja Krajinovic |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 21
Issue 2
Pg. 329-34
(Jan 15 2015)
ISSN: 1557-3265 [Electronic] United States |
PMID | 24907114
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | ©2014 American Association for Cancer Research. |
Chemical References |
- Antineoplastic Agents
- Asparaginase
- Aspartate-Ammonia Ligase
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Topics |
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Asparaginase
(adverse effects, therapeutic use)
- Aspartate-Ammonia Ligase
(genetics)
- Cell Line, Tumor
- Child
- Female
- Gene Frequency
- Genetic Association Studies
- Haplotypes
- Humans
- Male
- Polymorphism, Single Nucleotide
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy, enzymology, genetics)
- Repetitive Sequences, Nucleic Acid
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