title: Significant association between polymorphism of the erythropoietin gene promoter and myelodysplastic syndrome.
abstract: BACKGROUND
  Myelodysplastic syndrome (MDS) may be induced by certain mutagenic environmental or chemotherapeutic toxins; however, the role of susceptibility genes remains unclear. The G/G genotype of the single-nucleotide polymorphism (SNP) rs1617640 in the erythropoietin (EPO) promoter has been shown to be associated with decreased EPO expression. We examined the association of rs1617640 genotype with MDS.
  
  
  METHODS
  We genotyped the EPO rS1617640 SNP in 189 patients with MDS, 257 with acute myeloid leukemia (AML), 106 with acute lymphoblastic leukemia, 97 with chronic lymphocytic leukemia, 353 with chronic myeloid leukemia, and 95 healthy controls.
  
  
  RESULTS
  The G/G genotype was significantly more common in MDS patients (47/187; 25.1%) than in controls (6/95; 6.3%) or in patients with other leukemias (101/813; 12.4%) (all P < 0.001). Individuals with the G/G genotype were more likely than those with other genotypes to have MDS (odd ratio = 4.98; 95% CI = 2.04-12.13). Clinical and follow up data were available for 112 MDS patients and 186 AML patients. There was no correlation between EPO promoter genotype and response to therapy or overall survival in MDS or AML. In the MDS group, the GG genotype was significantly associated with shorter complete remission duration, as compared with the TT genotype (P = 0.03). Time to neutrophils recovery after therapy was significantly longer in MDS patients with the G/G genotype (P = 0.02).
  
  
  CONCLUSIONS
  These findings suggest a strong association between the rs1617640 G/G genotype and MDS. Further studies are warranted to investigate the utility of screening for this marker in individuals exposed to environmental toxins or chemotherapy.
authors.affiliation: Department of Hematology/Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA.
authors.forename: Wanlong
authors.initials: W
authors.lastname: Ma
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Ke
authors.initials: K
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiuqiang
authors.initials: X
authors.lastname: Wang
authors.forename: Clifford
authors.initials: C
authors.lastname: Chen
authors.forename: Amber C
authors.initials: AC
authors.lastname: Donahue
authors.forename: Zhong
authors.initials: Z
authors.lastname: Zhang
authors.forename: Chen-Hsiung
authors.initials: CH
authors.lastname: Yeh
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Neil
authors.initials: N
authors.lastname: Caporaso
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.forename: Maher
authors.initials: M
authors.lastname: Albitar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004921:Erythropoietin / Q000235:genetics*; D056726:Genetic Association Studies; D005838:Genotype; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive; D015470:Leukemia, Myeloid, Acute; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics* / Q000628:therapy; D011110:Polymorphism, Genetic / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D011401:Promoter Regions, Genetic / Q000235:genetics*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004921:Erythropoietin