Vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (NOS3) polymorphisms are associated with high relapse risk in childhood acute lymphoblastic leukemia (ALL)

BackgroundAngiogenesis has been shown as an important process in hematological malignancies. It consists in endothelial proliferation, migration, and tube formation following pro-angiogenic factors releasing, specially the vascular endothelial growth factor (VEGF), which angiogenic effect seems to be dependent on nitric oxide (NO). We examined the association among functional polymorphisms in these two angiogenesis related genes: VEGF (−2578C>A, −1154G>A, and −634G>C) and NOS3 (−786T>C, intron 4 b>a, and Glu298Asp) with prognosis of childhood acute lymphoblastic leukemia (ALL).MethodsThe genotypes were determined and haplotypes estimated in 105 ALL patients that were divided in 2 groups: high risk (HR) and low risk of relapse (LR) patients. In addition, event-free survival curves according to genotypes were assessed.ResultsThe group HR compared to the LR showed a higher frequency of the alleles −2578C and −634C and the haplotype CGC for VEGF (0.72 vs. 0.51, p < 0.008; 0.47 vs. 0.26, p < 0.008; and 42.1 vs. 14.5, p < 0.006; respectively) and a lower frequency of the haplotype CbGlu (0.4 vs. 8.8,p < 0.006), for NOS3.ConclusionPolymorphisms of VEGF and NOS3 genes are associated with high risk of relapse, therefore may have a prognostic impact in childhood ALL.