Impact of NOD2 polymorphisms on infectious complications following chemotherapy in patients with acute myeloid leukaemia

Ann Hematol. 2013 Aug;92(8):1071-7. doi: 10.1007/s00277-013-1734-0. Epub 2013 Apr 5.

Abstract

We sought to investigate the relationship between polymorphisms of the NOD2 gene and infectious complications following intensive induction chemotherapy in patients with acute myeloid leukaemia (AML). We hypothesised that single nucleotide polymorphisms (SNPs) of the NOD2 gene are associated with a higher rate of infections during the phase of severe neutropenia. In 131 AML patients receiving induction therapy, the presence of the three most frequent polymorphisms of NOD2 (Arg702Trp, Gly908Arg, Leu1007fsinsC) was analysed. SNP analyses by means of genomic PCR incorporating fluorescence-labelled probes with characteristic melting curves were performed using the LightCycler platform. Our data suggest a significantly lower probability of mucositis or enteritis in AML patients lacking any of the three evaluated NOD2 polymorphisms. Furthermore, bloodstream cultures of AML patients carrying either a missense or a frameshift mutation of NOD2 were significantly more frequently tested positive concerning Streptococcus spp. In contrast, the presence of NOD2 polymorphisms had no impact on such important infectious complications as systemic inflammatory response syndrome or sepsis, the rate of central venous catheter infections or the incidence of pneumonia including fungal infections. Our data represent one of the first reports investigating the impact of polymorphisms of the innate immune system on infectious complications in patients with neutropenia following chemotherapy. A correlation between NOD2 polymorphisms and infectious events in AML patients is demonstrated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Bacterial Infections / etiology*
  • Female
  • Frameshift Mutation*
  • Genetic Predisposition to Disease
  • Humans
  • Immunity, Innate
  • Immunocompromised Host
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Middle Aged
  • Mutation, Missense*
  • Mycoses / etiology
  • Neoplasm Proteins / genetics*
  • Neutropenia / chemically induced
  • Neutropenia / complications
  • Nod2 Signaling Adaptor Protein / genetics*
  • Nod2 Signaling Adaptor Protein / physiology
  • Polymorphism, Single Nucleotide*
  • Young Adult

Substances

  • NOD2 protein, human
  • Neoplasm Proteins
  • Nod2 Signaling Adaptor Protein