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Genomewide Approach Validates Thiopurine Methyltransferase Activity Is a Monogenic Pharmacogenomic Trait

We performed a genomewide association study (GWAS) of primary erythrocyte thiopurine S‐methyltransferase (TPMT) activity in children with leukemia (n = 1,026). Adjusting for age and ancestry, TPMT was the only gene that reached genomewide significance (top hit rs1142345 or 719A>G; P = 8.6 × 10‐61...

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Published in:Clinical pharmacology and therapeutics 2017-03, Vol.101 (3), p.373-381
Main Authors: Liu, C, Yang, W, Pei, D, Cheng, C, Smith, C, Landier, W, Hageman, L, Chen, Y, Yang, JJ, Crews, KR, Kornegay, N, Karol, SE, Wong, FL, Jeha, S, Sandlund, JT, Ribeiro, RC, Rubnitz, JE, Metzger, ML, Pui, C‐H, Evans, WE, Bhatia, S, Relling, MV
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Language:English
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Summary:We performed a genomewide association study (GWAS) of primary erythrocyte thiopurine S‐methyltransferase (TPMT) activity in children with leukemia (n = 1,026). Adjusting for age and ancestry, TPMT was the only gene that reached genomewide significance (top hit rs1142345 or 719A>G; P = 8.6 × 10‐61). Additional genetic variants (in addition to the three single‐nucleotide polymorphisms [SNPs], rs1800462, rs1800460, and rs1142345, defining TPMT clinical genotype) did not significantly improve classification accuracy for TPMT phenotype. Clinical mercaptopurine tolerability in 839 patients was related to TPMT clinical genotype (P = 2.4 × 10‐11). Using 177 lymphoblastoid cell lines (LCLs), there were 251 SNPs ranked higher than the top TPMT SNP (rs1142345; P = 6.8 × 10‐5), revealing a limitation of LCLs for pharmacogenomic discovery. In a GWAS, TPMT activity in patients behaves as a monogenic trait, further bolstering the utility of TPMT genetic testing in the clinic.
ISSN:0009-9236
1532-6535
DOI:10.1002/cpt.463