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Characteristics of white blood cell count in acute lymphoblastic leukemia : A COST LEGEND phenotype-genotype study

Characteristics of white blood cell count in acute lymphoblastic leukemia : A COST LEGEND phenotype-genotype study


Title: Characteristics of white blood cell count in acute lymphoblastic leukemia : A COST LEGEND phenotype-genotype study
Author: Helenius, Marianne
Vaitkeviciene, Goda
Abrahamsson, Jonas
Jónsson, Ólafur Gisli
Lund, Bendik
Harila-Saari, Arja
Vettenranta, Kim
Mikkel, Sirje
Stanulla, Martin
Lopez-Lopez, Elixabet
... 7 more authors Show all authors
Date: 2022-06
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
Series: Pediatric Blood and Cancer; 69(6)
ISSN: 1545-5009
DOI: https://doi.org/10.1002/pbc.29582
Subject: Barnalæknisfræði; Bráðahvítblæði; Genome-Wide Association Study; Genotype; Humans; Leukocyte Count; Phenotype; Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma; Prognosis
URI: https://hdl.handle.net/20.500.11815/3186

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Citation:

Helenius , M , Vaitkeviciene , G , Abrahamsson , J , Jónsson , Ó G , Lund , B , Harila-Saari , A , Vettenranta , K , Mikkel , S , Stanulla , M , Lopez-Lopez , E , Waanders , E , Madsen , H O , Marquart , H V , Modvig , S , Gupta , R , Schmiegelow , K & Nielsen , R L 2022 , ' Characteristics of white blood cell count in acute lymphoblastic leukemia : A COST LEGEND phenotype-genotype study ' , Pediatric Blood and Cancer , vol. 69 , no. 6 , e29582 . https://doi.org/10.1002/pbc.29582

Abstract:

BACKGROUND: White blood cell count (WBC) as a measure of extramedullary leukemic cell survival is a well-known prognostic factor in acute lymphoblastic leukemia (ALL), but its biology, including impact of host genome variants, is poorly understood. METHODS: We included patients treated with the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-2008 protocol (N = 2347, 72% were genotyped by Illumina Omni2.5exome-8-Bead chip) aged 1-45 years, diagnosed with B-cell precursor (BCP-) or T-cell ALL (T-ALL) to investigate the variation in WBC. Spline functions of WBC were fitted correcting for association with age across ALL subgroups of immunophenotypes and karyotypes. The residuals between spline WBC and actual WBC were used to identify WBC-associated germline genetic variants in a genome-wide association study (GWAS) while adjusting for age and ALL subtype associations. RESULTS: We observed an overall inverse correlation between age and WBC, which was stronger for the selected patient subgroups of immunophenotype and karyotypes (ρBCP-ALL = -.17, ρT-ALL = -.19; p < 3 × 10-4 ). Spline functions fitted to age, immunophenotype, and karyotype explained WBC variation better than age alone (ρ = .43, p << 2 × 10-6 ). However, when the spline-adjusted WBC residuals were used as phenotype, no GWAS significant associations were found. Based on available annotation, the top 50 genetic variants suggested effects on signal transduction, translation initiation, cell development, and proliferation. CONCLUSION: These results indicate that host genome variants do not strongly influence WBC across ALL subsets, and future studies of why some patients are more prone to hyperleukocytosis should be performed within specific ALL subsets that apply more complex analyses to capture potential germline variant interactions and impact on WBC.

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© 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.

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