Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Acute Leukemias

Prognostic role of glutathione S-transferase polymorphisms in acute myeloid leukemia

Abstract

Glutathione S-transferases (GSTs) are phase II detoxification enzymes involved in the metabolism of carcinogens and anticancer drugs, known also to interact with kinase complexes during oxidative or chemical stress-induced apoptosis. We were interested whether their polymorphic variants may account for differences in outcome of patients with acute myeloid leukemia (AML) following chemotherapy. We studied the prognostic role of polymorphisms in three GST genes (GSTP1/M1/T1) in a large patient cohort of the German Austrian Acute Myeloid Leukemia Study Group, treated according to prospective multicenter clinical trials (AML HD98A: 254 patients; AML HD98-B: 100 patients), with a median follow-up of 46 months. Looking at short-term adverse drug reactions, homozygous carriers of the GSTP1*105 Val allele had a faster neutrophil and platelet recovery (P=0.002 and 0.02, respectively) and a reduced need of red cell and platelet transfusions (P=0.01 and 0.03, respectively). Response to induction chemotherapy did not vary according to GST polymorphisms. Multivariable Cox regression models revealed a significant better relapse-free (RFS) and overall survival for the GSTP1*105 Val (P=0.003 and 0.03, respectively), whereas GSTT1 and GSTM1 genotypes had no significant impact. The favorable impact of GSTP1*105 Val on RFS seems to be restricted to the subgroup of patients exhibiting a normal karyotype.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Salinas AE, Wong MG . Glutathione S-transferases—a review. Curr Med Chem 1999; 6: 279–309.

    CAS  PubMed  Google Scholar 

  2. Shen H, Kauvar L, Tew KD . Importance of glutathione and associated enzymes in drug response. Oncol Res 1997; 9: 295–302.

    CAS  PubMed  Google Scholar 

  3. Tew KD, Ronai Z . GST function in drug and stress response. Drug Resist Updat 1999; 2: 143–147.

    Article  CAS  PubMed  Google Scholar 

  4. Townsend DM, Tew KD . The role of glutathione-S-transferase in anti-cancer drug resistance. Oncogene 2003; 22: 7369–7375.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Wang W, Liu G, Zheng J . Human renal UOK130 tumor cells: a drug resistant cell line with highly selective over-expression of glutathione S-transferase-pi isozyme. Eur J Pharmacol 2007; 568: 61–67.

    Article  CAS  PubMed  Google Scholar 

  6. Adler V, Yin Z, Fuchs SY, Benezra M, Rosario L, Tew KD et al. Regulation of JNK signaling by GSTp. EMBO J 1999; 18: 1321–1334.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Dorion S, Lambert H, Landry J . Activation of the p38 signaling pathway by heat shock involves the dissociation of glutathione S-transferase Mu from Ask1. J Biol Chem 2002; 277: 30792–30797.

    Article  CAS  PubMed  Google Scholar 

  8. Bernardini S, Bernassola F, Cortese C, Ballerini S, Melino G, Motti C et al. Modulation of GST P1-1 activity by polymerization during apoptosis. J Cell Biochem 2000; 77: 645–653.

    Article  CAS  PubMed  Google Scholar 

  9. Bernardini S, Bellincampi L, Ballerini S, Ranalli M, Pastore A, Cortese C et al. Role of GST P1-1 in mediating the effect of etoposide on human neuroblastoma cell line Sh-Sy5y. J Cell Biochem 2002; 86: 340–347.

    Article  CAS  PubMed  Google Scholar 

  10. Davies SM, Robison LL, Buckley JD, Tjoa T, Woods WG, Radloff GA et al. Glutathione S-transferase polymorphisms and outcome of chemotherapy in childhood acute myeloid leukemia. J Clin Oncol 2001; 19: 1279–1287.

    Article  PubMed  Google Scholar 

  11. Stanulla M, Schrappe M, Brechlin AM, Zimmerman M, Welte K . Polymorphisms within glutathione S-transferase genes (GSTM1, GSTT1, GSTP1) and risk of relapse in childhood B-cell precursor acute lymphoblastic leukemia: a case–control study. Blood 2000; 95: 1222–1228.

    CAS  PubMed  Google Scholar 

  12. Voso MT, D'Alo F, Putzulu R, Mele L, Scardocci A, Chiusolo P et al. Negative prognostic value of glutathione S-transferase (GSTM1 and GSTT1) deletions in adult acute myeloid leukemia. Blood 2002; 100: 2703–2707.

    Article  CAS  PubMed  Google Scholar 

  13. Schlenk RF, Dohner K, Pralle H, Götze K, Pfreundschuh M, Kneba M et al. Risk-adapted therapy in younger adults with acute myeloid leukemia: results of the AMLHD98A trial of the AMLSG. Blood 2006; 108: [abstract 14].

  14. Schlenk RF, Fröhling S, Hartmann F, Fischer JT, Glasmacher A, del Valle F et al. Phase III study of all-trans retinoic acid in previously untreated patients 61 years or older with acute myeloid leukemia. Leukemia 2004; 18: 1798–1803.

    Article  CAS  PubMed  Google Scholar 

  15. Schlenk RF, Fröhling S, Hartmann F, Fischer JT, Glasmacher A, Del Valle F et al. Intensive consolidation versus oral maintenance therapy in patients 61 years or older with acute myeloid leukemia in first remission: results of second randomization of the AML HD98-B treatment Trial. Leukemia 2006; 20: 748–750.

    Article  CAS  PubMed  Google Scholar 

  16. Fröhling S, Schlenk RF, Kayser S, Morhardt M, Benner A, Döhner K et al. Cytogenetics and age are major determinants of outcome in intensively treated acute myeloid leukemia patients older than 60 years: results from AMLSG trial AML HD98-B. Blood 2006; 108: 3280–3288.

    Article  PubMed  Google Scholar 

  17. Harries LW, Stubbins MJ, Forman D, Howard GC, Wolf CR . Identification of genetic polymorphisms at the glutathione S-transferase Pi locus and association with susceptibility to bladder, testicular and prostate cancer. Carcinogenesis 1997; 18: 641–644.

    Article  CAS  PubMed  Google Scholar 

  18. Cheson BD, Bennett JM, Kopecky KJ, Büchner T, Willman CL, Estey EH et al. Revised recommendations of the international working group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol 2003; 21: 4642–4649.

    Article  Google Scholar 

  19. Gray RJ . A class of k-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat 1988; 16: 1141–1154.

    Article  Google Scholar 

  20. Welfare M, Monesola Adeokun A, Daly AK . Polymorphisms in GSTP1, GSTM1, and GSTT1 and susceptibility to colorectal cancer. Cancer Epidemiol Biomarkers Prev 1999; 8: 289–292.

    CAS  PubMed  Google Scholar 

  21. Krajinovic M, Ghadirian P, Richer C, Sinnett H, Gandini S, Perret C et al. Genetic susceptibility to breast cancer in French-Canadians: role of carcinogen-metabolizing enzymes and gene-environment interactions. Int J Cancer 2001; 92: 220–225.

    Article  CAS  PubMed  Google Scholar 

  22. Estey E, Döhner H . Acute myeloid leukaemia. Lancet 2006; 368: 1894–1907.

    Article  PubMed  Google Scholar 

  23. Schlenk RF, Döhner K, Krauter J, Fröhling S, Corbacioglu A, Bullinger L et al. Mutations and outcome of treatment in cytogenetically normal acute myeloid leukemia. N Engl J Med 2008; 358: 1909–1918.

    Article  CAS  PubMed  Google Scholar 

  24. Czerwinski M, Gibbs JP, Slattery JT . Busulfan conjugation by glutathione S-transferases alpha, mu, and pi. Drug Metab Dispos 1996; 24: 1015–1019.

    CAS  PubMed  Google Scholar 

  25. Niitsu Y, Takahashi Y, Ban N, Takayama T, Saito T, Katahira T et al. A proof of glutathione S-transferase-pi-related multidrug resistance by transfer of antisense gene to cancer cells and sense gene to bone marrow stem cell. Chem Biol Interact 1998; 111–112: 325–332.

    Article  PubMed  Google Scholar 

  26. Morrow CS, Smitherman PK, Townsend AJ . Combined expression of multidrug resistance protein (MRP) and glutathione S-transferase P1-1 (GSTP1-1) in MCF7 cells and high level resistance to the cytotoxicities of ethacrynic acid but not oxazaphosphorines or cisplatin. Biochem Pharmacol 1998; 56: 1013–1021.

    Article  CAS  PubMed  Google Scholar 

  27. Goto S, Ihara Y, Urata Y, Izumi S, Abe K, Koji T et al. Doxorubicin-induced DNA intercalation and scavenging by nuclear glutathione S-transferase pi. FASEB J 2001; 15: 2702–2714.

    Article  CAS  PubMed  Google Scholar 

  28. Zimniak P, Nanduri B, Pikuła S, Bandorowicz-Pikuła J, Singhal SS, Srivastava SK et al. Naturally occurring human glutathione S-transferase GSTP1-1 isoforms with isoleucine and valine in position 104 differ in enzymic properties. Eur J Biochem 1994; 224: 893–899.

    Article  CAS  Google Scholar 

  29. Watson MA, Stewart RK, Smith GB, Massey TE, Bell DA . Human glutathione S-transferase P1 polymorphisms: relationship to lung tissue enzyme activity and population frequency distribution. Carcinogenesis 1998; 19: 275–280.

    Article  CAS  PubMed  Google Scholar 

  30. Srivastava SK, Singhal SS, Hu X, Awasthi YC, Zimniak P, Singh SV . Differential catalytic efficiency of allelic variants of human glutathione S-transferase Pi in catalyzing the glutathione conjugation of thiotepa. Arch Biochem Biophys 1999; 366: 89–94.

    Article  CAS  PubMed  Google Scholar 

  31. Sweeney C, McClure GY, Fares MY, Stone A, Coles BF, Thompson PA et al. Association between survival after treatment for breast cancer and glutathione S-transferase P1 Ile105Val polymorphism. Cancer Res 2000; 60: 5621–5624.

    CAS  PubMed  Google Scholar 

  32. Stoehlmacher J, Park DJ, Zhang W, Groshen S, Tsao-Wei DD, Yu MC et al. Association between glutathione S-transferase P1, T1, and M1 genetic polymorphism and survival of patients with metastatic colorectal cancer. J Natl Cancer Inst 2002; 94: 936–942.

    Article  CAS  PubMed  Google Scholar 

  33. Hohaus S, Di Ruscio A, Di Febo A, Massini G, D'Alo F, Guidi F et al. Glutathione S-transferase P1 genotype and prognosis in Hodgkin's lymphoma. Clin Cancer Res 2005; 11: 2175–2179.

    Article  CAS  PubMed  Google Scholar 

  34. Yang G, Shu XO, Ruan ZX, Cai QY, Jin F, Gao YT et al. Genetic polymorphisms in glutathione-S-transferase genes (GSTM1, GSTT1, GSTP1) and survival after chemotherapy for invasive breast carcinoma. Cancer 2005; 103: 52–58.

    Article  CAS  PubMed  Google Scholar 

  35. Dasgupta RK, Adamson PJ, Davies FE, Rollinson S, Roddam PL, Ashcroft AJ et al. Polymorphic variation in GSTP1 modulates outcome following therapy for multiple myeloma. Blood 2003; 102: 2345–2350.

    Article  CAS  PubMed  Google Scholar 

  36. Zhong S, Huang M, Yang X, Liang L, Wang Y, Romkes M et al. Relationship of glutathione S-transferase genotypes with side-effects of pulsed cyclophosphamide therapy in patients with systemic lupus erythematosus. Br J Clin Pharmacol 2006; 62: 457–472.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Yokomizo A, Yamamoto K, Kinukawa N, Tsunoda T, Koga H, Naito S . Association analysis of glutathione-S-transferase P1 (GSTP1) polymorphism with urothelial cancer susceptibility and myelosuppression after M-VAC chemotherapy. Int J Urol 2007; 14: 500–504.

    Article  CAS  PubMed  Google Scholar 

  38. Gate L, Majumdar RS, Lunk A, Tew KD . Increased myeloproliferation in glutathione S-transferase pi-deficient mice is associated with a deregulation of JNK and Janus kinase/STAT pathways. J Biol Chem 2004; 279: 8608–8616.

    Article  CAS  PubMed  Google Scholar 

  39. Jacobs-Helber SM, Sawyer ST . Jun N-terminal kinase promotes proliferation of immature erythroid cells and erythropoietin-dependent cell lines. Blood 2004; 104: 696–703.

    Article  CAS  PubMed  Google Scholar 

  40. Ruscoe JE, Rosario LA, Wang T, Gaté L, Arifoglu P, Wolf CR et al. Pharmacologic or genetic manipulation of glutathione S-transferase P1-1 (GSTpi) influences cell proliferation pathways. J Pharmacol Exp Ther 2001; 298: 339–345.

    CAS  PubMed  Google Scholar 

  41. Stofega MR, Cheng M, Ma H, Sambucetti L, Keck JG, Brown GL et al. Telintra™ (TLK199) enhances granulocyte colony-stimulating factor production. Blood 2006; 108: [abstract 1161].

  42. Raza A, Callander N, Ochoa L, Piro L, Emanuel P, Guba S et al. Hematologic improvement (HI) by TLK199 (Telintra™), a novel glutathione analog, in myelodysplastic syndrome: phase 2 study results. Blood 2005; 106: [abstract 2520].

  43. Raza A, Melcert M, Galili N, Smith SE, Godwin JE, Young S et al. Phase 1 dose escalation study of TLK199 tablets (Telintra), a novel glutathione analog, in myelodysplastic syndrome. Blood 2007; 110: [Abstract 1454].

  44. Davies SM, Bhatia S, Ross JA, Kiffmeyer WR, Gaynon PS, Radloff GA et al. Glutathione S-transferase genotypes, genetic susceptibility, and outcome of therapy in childhood acute lymphoblastic leukemia. Blood 2002; 100: 67–71.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from Associazione Italiana per la Ricerca sul Cancro (AIRC).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M T Voso.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Voso, M., Hohaus, S., Guidi, F. et al. Prognostic role of glutathione S-transferase polymorphisms in acute myeloid leukemia. Leukemia 22, 1685–1691 (2008). https://doi.org/10.1038/leu.2008.169

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leu.2008.169

Keywords

This article is cited by

Search

Quick links