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Yin and yang of cytidine deaminase roles in clinical response to azacitidine in the elderly: a pharmacogenetics tale
- Source :
- Pharmacogenomics, Pharmacogenomics, Future Medicine, 2015, 16 (17), pp.1907-12. ⟨10.2217/pgs.15.135⟩
- Publication Year :
- 2015
- Publisher :
- HAL CCSD, 2015.
-
Abstract
- International audience; Azacitidine is a mainstay for treating hematological disorders. Azacitidine is metabolized by cytidine deaminase, coded by a highly polymorphic gene. Here, we present two elderly patients with opposite clinical outcomes after azacitidine treatment. First, an acute myeloid leukemia patient showed life-threatening toxicities, but outstanding complete remission, after a single round of azacitidine. Further investigations showed that this patient was cytidine deaminase 79A>C (rs2072671) homozygous with a marked deficient phenotype. Next, a chronic myelomonocytic leukemia patient displayed complete lack of response despite several cycles of azacitidine. This patient had a rapid-deaminator phenotype linked to the -31delC deletion (rs3215400). These polymorphisms lead to opposite clinical outcomes in patients with myelodysplastic syndromes treated with azacitidine, thus suggesting that determining cytidine deaminase status could help to forecast clinical outcome.
- Subjects :
- Oncology
Male
medicine.medical_specialty
Antimetabolites, Antineoplastic
azacitidine
Azacitidine
efficacy
Chronic myelomonocytic leukemia
[SDV.CAN]Life Sciences [q-bio]/Cancer
Biology
Internal medicine
Genetics
medicine
Humans
genetic polymorphism
cytidine deaminase
Pharmacology
Aged, 80 and over
Myelodysplastic syndromes
Myeloid leukemia
toxicity
Cytidine deaminase
medicine.disease
Phenotype
myelodysplastic syndromes
3. Good health
Pharmacogenetics
Hematologic Neoplasms
Immunology
Molecular Medicine
Gene polymorphism
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 14622416 and 17448042
- Database :
- OpenAIRE
- Journal :
- Pharmacogenomics, Pharmacogenomics, Future Medicine, 2015, 16 (17), pp.1907-12. ⟨10.2217/pgs.15.135⟩
- Accession number :
- edsair.doi.dedup.....3d2d022b93b21a67242e364501940e04