[Genetic polymorphism and outcome in acute lymphoblastic leukaemia of childhood].
Current treatment strategies of leukaemia use risk factors existing at the time of diagnosis to establish risk-adapted therapy. This approach currently results in overall 95% rate of complete remission in paediatric acute lymphoblastic leukemia (ALL). However, as many as 30% of patients suffer from relapse and majority of children with ALL is profoundly affected by toxicity of anticancer drugs. In our study the probability of event free survival in children presenting with normal blast karyotype and treated according to BFM 90 protocol was 75%. This suggests the existence of factors independent from leukaemia genetic background, which influences the outcome of patients with ALL. This review is focused on genetic and functional polymorphism of enzymes that have or may have the influence on metabolism of drugs included in treatment protocol for ALL in children. Basic enzymes of anticancer drug metabolic pathways are described and frequency of their polymorphisms in Caucasian population is discussed.
Jurkowska
Monika
M
Zakład Genetyki Medycznej, Instytutu Matki i Dziecka, Warszawa. mjurkowska@gazeta.pl
Malinowska
Iwona
I
Bal
Jerzy
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D020022:Genetic Predisposition to Disease; D005982:Glutathione Transferase / Q000378:metabolism; D006801:Humans; D011110:Polymorphism, Genetic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000201:enzymology / Q000235:genetics* / Q000378:metabolism*; D044465:White People / Q000235:genetics
D003577:Cytochrome P-450 Enzyme System; D005982:Glutathione Transferase