title: Pharmacogenetics of childhood acute lymphoblastic leukemia.
abstract: Acute lymphoblastic leukemia (ALL) is the major pediatric cancer in developed countries. Although treatment outcome has improved owing to advances in chemotherapy, there is still a group of patients for which therapy fails while some patients experience severe toxicity. In the last few years, several pharmacogenetic studies have been performed to search for markers of outcome and toxicity in pediatric ALL. However, to date, TPMT is the only pharmacogenetic marker in ALL with clinical guidelines for drug dosing. In this article, we will provide an overview of the most important findings carried out in pharmacogenetics for pediatric ALL, such as the interest drawn by methotrexate transporters in the context of methotrexate treatment. Even if most of the studies are centered on coding genes, we will also point to new approaches focusing on noncoding regions and epigenetic variation that could be interesting for consideration in the near future.
authors.affiliation: Department of Genetics, Physical Anthropology & Animal Physiology, Faculty of Medicine & Odontology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain.
authors.forename: Elixabet
authors.initials: E
authors.lastname: Lopez-Lopez
authors.forename: Angela
authors.initials: A
authors.lastname: Gutierrez-Camino
authors.forename: Nerea
authors.initials: N
authors.lastname: Bilbao-Aldaiturriaga
authors.forename: Maria
authors.initials: M
authors.lastname: Pombar-Gomez
authors.forename: Idoia
authors.initials: I
authors.lastname: Martin-Guerrero
authors.forename: Africa
authors.initials: A
authors.lastname: Garcia-Orad
mesh_terms: D002648:Child; D002675:Child, Preschool; D044127:Epigenesis, Genetic; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D008727:Methotrexate
keywords: acute lymphoblastic leukemia; childhood; outcome; pharmacogenetics; toxicity; treatment