The relationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy.
OBJECTIVE
The primary purpose of this study was to compare the neuropsychological performance of long-term survivors of breast cancer and lymphoma treated with standard dose chemotherapy who carried the epsilon 4 allele of the Apolipoprotein E (APOE) gene to those who carry other APOE alleles.


METHODS
Long-term survivors (mean=8.8+/-4.3 years post-treatment) of breast cancer (N=51, age=55.9+/-8.8) or lymphoma (N=29, age=55.8+/-11.6) who had been treated with standard-dose chemotherapy completed a standardized battery of neuropsychological and psychological tests. Survivors were also classified into two groups based on the presence (N=17) or absence (N=63) of at least one epsilon 4 allele of APOE.


RESULTS
Analysis of covariance, controlling for age, gender, education, diagnosis, and WRAT-3 reading subtest (a proxy measure of baseline IQ), indicated that survivors with at least one epsilon 4 allele scored significantly lower in the visual memory (p<0.03) and the spatial ability (p<0.05) domains and tended to score lower in the psychomotor functioning (p<0.08) domain as compared to survivors who did not carry an epsilon 4 allele. No group differences were found on depression, anxiety, or fatigue.


CONCLUSIONS
The results of this study provide preliminary support for the hypothesis that the epsilon 4 allele of APOE may be a potential genetic marker for increased vulnerability to chemotherapy-induced cognitive decline.
Ahles
Tim A
TA
Department of Psychiatry and Center for Psycho-Oncology Research, USA. tim.a.ahles@dartmouth.edu
Saykin
Andrew J
AJ
Noll
Walter W
WW
Furstenberg
Charlotte T
CT
Guerin
Stephen
S
Cole
Bernard
B
Mott
Leila A
LA
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001057:Apolipoproteins E / Q000235:genetics*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology* / Q000235:genetics; D005260:Female; D005819:Genetic Markers; D005838:Genotype; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy / Q000235:genetics* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D017741:Survivors / Q000523:psychology*
D001057:Apolipoproteins E; D005819:Genetic Markers