Association of Germline CHEK2 Gene Variants with Risk and Prognosis of Non-Hodgkin Lymphoma

PLoS One. 2015 Oct 27;10(10):e0140819. doi: 10.1371/journal.pone.0140819. eCollection 2015.

Abstract

The checkpoint kinase 2 gene (CHEK2) codes for the CHK2 protein, an important mediator of the DNA damage response pathway. The CHEK2 gene has been recognized as a multi-cancer susceptibility gene; however, its role in non-Hodgkin lymphoma (NHL) remains unclear. We performed mutation analysis of the entire CHEK2 coding sequence in 340 NHL patients using denaturing high-performance liquid chromatography (DHPLC) and multiplex ligation-dependent probe amplification (MLPA). Identified hereditary variants were genotyped in 445 non-cancer controls. The influence of CHEK2 variants on disease risk was statistically evaluated. Identified CHEK2 germline variants included four truncating mutations (found in five patients and no control; P = 0.02) and nine missense variants (found in 21 patients and 12 controls; P = 0.02). Carriers of non-synonymous variants had an increased risk of NHL development [odds ratio (OR) 2.86; 95% confidence interval (CI) 1.42-5.79] and an unfavorable prognosis [hazard ratio (HR) of progression-free survival (PFS) 2.1; 95% CI 1.12-4.05]. In contrast, the most frequent intronic variant c.319+43dupA (identified in 22% of patients and 31% of controls) was associated with a decreased NHL risk (OR = 0.62; 95% CI 0.45-0.86), but its positive prognostic effect was limited to NHL patients with diffuse large B-cell lymphoma (DLBCL) treated by conventional chemotherapy without rituximab (HR-PFS 0.4; 94% CI 0.17-0.74). Our results show that germ-line CHEK2 mutations affecting protein coding sequence confer a moderately-increased risk of NHL, they are associated with an unfavorable NHL prognosis, and they may represent a valuable predictive biomarker for patients with DLBCL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Checkpoint Kinase 2 / genetics*
  • DNA Mutational Analysis
  • DNA Repair / genetics
  • Female
  • Genetic Association Studies
  • Genetic Predisposition to Disease*
  • Germ Cells
  • Humans
  • Lymphoma, Non-Hodgkin / genetics*
  • Lymphoma, Non-Hodgkin / pathology
  • Male
  • Middle Aged
  • Mutation
  • Prognosis*
  • RNA Splicing / genetics

Substances

  • Checkpoint Kinase 2
  • CHEK2 protein, human

Grants and funding

This study was supported by the Charles University in Prague, project PRVOUK-P27/LF1/1, (http://www.cuni.cz/UKEN-1.html) to ZK and MT; project SVV UK 260148/2015, (http://www.cuni.cz/UKEN-1.html) to JH, FL, ZK, and PK; and Internal Grant Agency, Ministry of Health, Czech Republic, NT12193, (http://www.mzcr.cz) to MT. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.