title: MDM2 SNP309 and TP53 Arg72Pro interact to alter therapy-related acute myeloid leukemia susceptibility.
abstract: The p53 tumor suppressor directs the cellular response to many mechanistically distinct DNA-damaging agents and is selected against during the pathogenesis of therapy-related acute myeloid leukemia (t-AML). We hypothesized that constitutional genetic variation in the p53 pathway would affect t-AML risk. Therefore, we tested associations between patients with t-AML (n = 171) and 2 common functional p53-pathway variants, the MDM2 SNP309 and the TP53 codon 72 polymorphism. Although neither polymorphism alone influenced the risk of t-AML, an interactive effect was detected such that MDM2 TT TP53 Arg/Arg double homozygotes, and individuals carrying both a MDM2 G allele and a TP53 Pro allele, were at increased risk of t-AML (P value for interaction is .009). This interactive effect was observed in patients previously treated with chemotherapy but not in patients treated with radiotherapy, and in patients with loss of chromosomes 5 and/or 7, acquired abnormalities associated with prior exposure to alkylator chemotherapy. In addition, there was a trend toward shorter latency to t-AML in MDM2 GG versus TT homozygotes in females but not in males, and in younger but not older patients. These data indicate that the MDM2 and TP53 variants interact to modulate responses to genotoxic therapy and are determinants of risk for t-AML.
authors.affiliation: Department of Medicine, University of Chicago Cancer Research Center, University of Chicago, IL 60637, USA.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Ellis
authors.forename: Dezheng
authors.initials: D
authors.lastname: Huo
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yildiz
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Worrillow
authors.forename: Mekhala
authors.initials: M
authors.lastname: Banerjee
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Le Beau
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.forename: James M
authors.initials: JM
authors.lastname: Allan
authors.forename: Kenan
authors.initials: K
authors.lastname: Onel
mesh_terms: D000367:Age Factors; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D007951:Leukemia, Myeloid / Q000139:chemically induced / Q000235:genetics*; D008297:Male; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000235:genetics*; D011110:Polymorphism, Genetic; D051736:Proto-Oncogene Proteins c-mdm2 / Q000235:genetics*; D012307:Risk Factors; D012737:Sex Factors; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
chemical_list: D016159:Tumor Suppressor Protein p53; C497206:MDM2 protein, human; D051736:Proto-Oncogene Proteins c-mdm2