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Variability in transport and biotransformation of cytarabine is associated with its toxicity in peripheral blood mononuclear cells

    Sumit Parmar

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Angela Seeringer

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Dina Denich

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Franziska Gärtner

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Kai Pitterle

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Tatiana Syrovets

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    ,
    Barbara Ohmle

    Institute of Pharmacology of Natural Products & Clinical Pharmacology, University of Ulm, Germany

    &
    Published Online:https://doi.org/10.2217/pgs.10.200

    Aim: To adopt an individualized approach to assess cytarabine (ara-C) hematotoxicity, we studied the relationship between pharmacogenetic variability in the cytidine deaminase gene (CDA) and ara-C toxicity in native peripheral blood mononuclear cells from 100 healthy volunteers. Materials & methods: Peripheral blood mononuclear cells were incubated for 48 h with 3 µM ara-C, and cell viability was analyzed by flow cytometry with and without the addition of an equilibrative nucleoside transporter transport inhibitor. CDA promoter and exonic variants were genotyped to derive haplotypes for the CDA gene. Results: Significant between-subject variability was observed in ara-C toxicity (21-fold with 40.1% coefficient of variation compared with 1.2-fold within-subject variability [9.6% coefficient of variation]). Inhibition of hENT1 reversed ara-C cytotoxicity. The linked CDA promoter variants -451C>T, -92A>G, -31Del and the exonic 79A>C variant were associated with ara-C toxicity (p < 0.05). CDA*2A haplotype was associated with ara-C toxicity (p = 0.03). Conclusion: Genetic polymorphisms within CDA may be risk factors for ara-C-induced hematotoxicity.

    Original submitted 6 October 2010; Revision submitted 29 November 2010.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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