Analysis of genetic polymorphism in NQO1, GST-M1, GST-T1, and CYP3A4 in 469 Japanese patients with therapy-related Leukemia/Myelodysplastic Syndrome and de novo acute myeloid leukemia

Several genetic polymorphisms in metabolic activation or detoxification enz ymes have been associated with susceptibility to therapy-related leukemia a nd myelodysplastic leukemia (TRL/MDS). We analyzed gene polymorphisms of NA D(P)H:quinone oxidoreductase (NQO1), glutathione S-tranferase (GST)-M1 and -T1, and CYP3A4, the enzymes of which are capable of metabolizing anticance r drugs, in 58 patients with TRL/MDS and in 411 patients with de novo acute myeloid leukemia (AML). Homozygous Ser/Ser genotype of NQO1 at codon 187, causing loss of function, was more frequent in the patients with TRL/MDS (1 4 of 58, 24.1%; OR = 2.62) than in those with de novo AML (61 of 411, 15.6% ), and control (16 of 150, 10.6%; P = 0.002). Allelic frequencies of NQO1 w ere different between TRL/MDS and de novo AML (P = 0,01). In GST-MI and -T1 , the incidence of homologous deletion was similar among the three groups. The polymorphism of the 5' promoter region of CYP3A4 was not found in perso ns of Japanese ethnicity. These results suggest that the NQO1 polymorphism is significantly associated with the genetic risk of TRL/MDS.