Open Access Highly Accessed Research article

Significant association between polymorphism of the erythropoietin gene promoter and myelodysplastic syndrome

Wanlong Ma1, Hagop Kantarjian2, Ke Zhang1, Xi Zhang1, Xiuqiang Wang1, Clifford Chen1, Amber C Donahue1, Zhong Zhang1, Chen-Hsiung Yeh1, Susan O'Brien2, Guillermo Garcia-Manero2, Neil Caporaso3, Ola Landgren4 and Maher Albitar1*

Author Affiliations

1 Department of Hematology/Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA

2 Department of Leukemia, M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA

3 Division of Cancer Epidemiology and Genetics, Center for Cancer Research, National Cancer Institute, National Cancer Institute of Health, Bethesda, MD, USA

4 Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Cancer Institute of Health, Bethesda, MD, USA

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BMC Medical Genetics 2010, 11:163  doi:10.1186/1471-2350-11-163

Published: 16 November 2010



Myelodysplastic syndrome (MDS) may be induced by certain mutagenic environmental or chemotherapeutic toxins; however, the role of susceptibility genes remains unclear. The G/G genotype of the single-nucleotide polymorphism (SNP) rs1617640 in the erythropoietin (EPO) promoter has been shown to be associated with decreased EPO expression. We examined the association of rs1617640 genotype with MDS.


We genotyped the EPO rS1617640 SNP in 189 patients with MDS, 257 with acute myeloid leukemia (AML), 106 with acute lymphoblastic leukemia, 97 with chronic lymphocytic leukemia, 353 with chronic myeloid leukemia, and 95 healthy controls.


The G/G genotype was significantly more common in MDS patients (47/187; 25.1%) than in controls (6/95; 6.3%) or in patients with other leukemias (101/813; 12.4%) (all P < 0.001). Individuals with the G/G genotype were more likely than those with other genotypes to have MDS (odd ratio = 4.98; 95% CI = 2.04-12.13). Clinical and follow up data were available for 112 MDS patients and 186 AML patients. There was no correlation between EPO promoter genotype and response to therapy or overall survival in MDS or AML. In the MDS group, the GG genotype was significantly associated with shorter complete remission duration, as compared with the TT genotype (P = 0.03). Time to neutrophils recovery after therapy was significantly longer in MDS patients with the G/G genotype (P = 0.02).


These findings suggest a strong association between the rs1617640 G/G genotype and MDS. Further studies are warranted to investigate the utility of screening for this marker in individuals exposed to environmental toxins or chemotherapy.