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DISTINCT ASSOCIATIONS BETWEEN UGT1A1 GENE PROMOTER POLYMORPHISM AND HYPERBILIRUBINEMIA IN CML PATIENTS TREATED WITH NILOTINIB AND RADOTINIB
Author(s): ,
Soohyun Kim
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Soo Young Choi
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Sung-Eun Lee
Affiliations:
Department of Hematology,Seoul St. Mary’s Hospital, The Catholic University of Korea,Seoul,Korea, Republic Of
,
Hae Lyun Yoo
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Yun Jeong Oh
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Mi-Young Lee
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Eun-Jung Jang
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Mi-yeon Choi
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
,
Moon-mi Jang
Affiliations:
Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
Dong-Wook Kim
Affiliations:
Department of Hematology,Seoul St. Mary’s Hospital, The Catholic University of Korea,Seoul,Korea, Republic Of;Cancer Research Institute,The Catholic University of Korea,Seoul,Korea, Republic Of
(Abstract release date: 05/21/15) EHA Library. Kim S. 06/12/15; 102773; PB1729 Disclosure(s): The Catholic University of Korea
Cancer Research Institute
Soohyun Kim
Soohyun Kim
Contributions
Abstract
Abstract: PB1729

Type: Publication Only

Background
Second-generation BCR-ABL tyrosine kinase inhibitors (2nd generation TKIs) including nilotinib (NIL) and radotinib (RAD) are approved for the treatment of newly diagnosed and other TKI failed chronic myeloid leukemia (CML). Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene promoter polymorphism, distinct number of TA repeats in promoter,  has been reported for an association with  hyperbilirubinemia on nilotinib therapy (Singer et al. Leukemia (2007) 21, 2311–2315). However, the distribution of UGT1A1 (TA)7 repeat polymorphism differs greatly between Caucasians and Japanese, namely, the frequency of UGT1A1(TA)7 repeat polymorphism is high in Caucasians, whereas it is low in Asians (Beutler et al. Proc. Natl. Acad. Sci. USA 95 (1998) 95, 8170–8174 ).

Aims
The aim of this study was to investigate the association between UGT1A1 gene promoter polymorphism and hyperbilirubinemia in Korean CML patients treated with NIL and RAD as a frontline therapy.

Methods
A total of 94 newly diagnosed chronic phase CML patients who treated with frontline NIL (n=42) and RAD (n=52) was screened for UGT1A1 promoter polymorphism genotype analysis. We used the High Pure PCR Template Preparation Kit (Roche, Germany) to prepare genomic DNA from whole blood and genotyped by direct sequencing of the 253- to 255-bp fragments produced by PCR.

Results
The (TA)6/(TA)6 homozygote and (TA)6/(TA)7 heterozygote were seen in all genotyped population and frequency of (TA)6/(TA)6 homozygote was 77.7% (73/94) in our patients. (TA)6 /(TA)6  homozygote predominated with 78.9% of the alleles in the RAD group and 76.2% in the NIL group. Relative risk for each genotype presented in Table 1, with hyperbilirubinemia defined as CTCAE grade 2 or greater observed at any post-baseline point. The relative risks for 6/6 genotype versus 6/7 genotype was 3.9 with 95% CIs of (0.7, 20.3) in the RAD group compared with 10.5 (2.0, 54.3) in the NIL group and NIL group showed significantly high association with UGT1A1 gene promoter polymorphism (P<0.05).

Summary
This finding suggests that UGT1A1 gene promoter polymorphism may be an important determinant of hyperbilirubinemia in CML patients with NIL therapy, but not in RAD. However other mechanisms should be explored in patients who have significant hyperbilirubinemia with RAD therapy. Updated data with longer follow-up duration will be presented in the meeting.

Keyword(s): Hyperbilirubinemia



Session topic: Publication Only
Abstract: PB1729

Type: Publication Only

Background
Second-generation BCR-ABL tyrosine kinase inhibitors (2nd generation TKIs) including nilotinib (NIL) and radotinib (RAD) are approved for the treatment of newly diagnosed and other TKI failed chronic myeloid leukemia (CML). Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene promoter polymorphism, distinct number of TA repeats in promoter,  has been reported for an association with  hyperbilirubinemia on nilotinib therapy (Singer et al. Leukemia (2007) 21, 2311–2315). However, the distribution of UGT1A1 (TA)7 repeat polymorphism differs greatly between Caucasians and Japanese, namely, the frequency of UGT1A1(TA)7 repeat polymorphism is high in Caucasians, whereas it is low in Asians (Beutler et al. Proc. Natl. Acad. Sci. USA 95 (1998) 95, 8170–8174 ).

Aims
The aim of this study was to investigate the association between UGT1A1 gene promoter polymorphism and hyperbilirubinemia in Korean CML patients treated with NIL and RAD as a frontline therapy.

Methods
A total of 94 newly diagnosed chronic phase CML patients who treated with frontline NIL (n=42) and RAD (n=52) was screened for UGT1A1 promoter polymorphism genotype analysis. We used the High Pure PCR Template Preparation Kit (Roche, Germany) to prepare genomic DNA from whole blood and genotyped by direct sequencing of the 253- to 255-bp fragments produced by PCR.

Results
The (TA)6/(TA)6 homozygote and (TA)6/(TA)7 heterozygote were seen in all genotyped population and frequency of (TA)6/(TA)6 homozygote was 77.7% (73/94) in our patients. (TA)6 /(TA)6  homozygote predominated with 78.9% of the alleles in the RAD group and 76.2% in the NIL group. Relative risk for each genotype presented in Table 1, with hyperbilirubinemia defined as CTCAE grade 2 or greater observed at any post-baseline point. The relative risks for 6/6 genotype versus 6/7 genotype was 3.9 with 95% CIs of (0.7, 20.3) in the RAD group compared with 10.5 (2.0, 54.3) in the NIL group and NIL group showed significantly high association with UGT1A1 gene promoter polymorphism (P<0.05).

Summary
This finding suggests that UGT1A1 gene promoter polymorphism may be an important determinant of hyperbilirubinemia in CML patients with NIL therapy, but not in RAD. However other mechanisms should be explored in patients who have significant hyperbilirubinemia with RAD therapy. Updated data with longer follow-up duration will be presented in the meeting.

Keyword(s): Hyperbilirubinemia



Session topic: Publication Only

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