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Gene Predicts Worse Outcome Post-Transplant in Leukemia

Alleles of the NOD2/CARD15 gene are associated with increased relapse risk

FRIDAY, Sept. 21 (HealthDay News) -- Patients with acute leukemia treated with hematopoietic stem cell transplant (HSCT) from an unrelated donor may be more likely to have a relapse and die if they have certain variants of the NOD2/CARD15 gene, which is involved in inflammation, according to a report in the Sept. 20 issue of the Journal of Clinical Oncology.

Steven G.E. Marsh, Ph.D., of the Royal Free Hospital in London, U.K., and colleagues genotyped 196 stem cell recipients and their unrelated donors to investigate the impact of NOD2/CARD15 gene single nucleotide polymorphisms on outcomes.

Median time of follow-up was 2.2 years. The presence of NOD2/CARD15 polymorphisms in the recipient/donor genotypes was associated with reduced overall survival and increased incidence of relapse compared to wild-type pairs. The polymorphisms had no apparent effect on the incidence of acute graft-versus-host disease.

"These data indicate an unrecognized role for the NOD2/CARD15 gene in unrelated donor HSCT for acute leukemia. The increased risk of disease relapse suggests that the wild-type gene product may contribute to a graft-versus-leukemia effect. These data suggest that NOD2/CARD15 genotyping before transplantation may contribute to prognosis and influence clinical management," the authors conclude.

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