DNA polymerase gamma variants and hepatotoxicity during maintenance therapy of childhood acute lymphoblastic leukemia: is there a causal relationship?

Tekla Harju*, Anri Hurme-Niiranen, Maria Suo-Palosaari, Stine Nygaard Nielsen, Reetta Hinttala, Kjeld Schmiegelow, Johanna Uusimaa, Arja Harila, Riitta Niinimäki

*Corresponding author af dette arbejde

Abstract

Hepatotoxicity is a frequent complication during maintenance therapy of acute lymphoblastic leukemia (ALL) with 6-mercaptopurine and methotrexate. Elevated levels of methylated 6-mercaptopurine metabolites (MeMP) are associated with hepatotoxicity. However, not all mechanisms are known that lead to liver failure in patients with ALL. Variants in the POLG gene, which encodes the catalytic subunit of mitochondrial DNA polymerase gamma (POLG1), have been related to drug-induced hepatotoxicity, for example, by sodium valproate. The association of common POLG variants with hepatotoxicity during maintenance therapy was studied in 34 patients with childhood ALL. Of the screened POLG variants, four different variants were detected in 12 patients. One patient developed severe hepatotoxicity without elevated MeMP levels and harbored a heterozygous POLG p.G517V variant, which was not found in the other patients.

OriginalsprogEngelsk
TidsskriftThe pharmacogenomics journal
Vol/bind23
Udgave nummer5
Sider (fra-til)105-111
Antal sider7
ISSN1470-269X
DOI
StatusUdgivet - sep. 2023

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