Characterization of Genetic Etiological Factors for Pediatric Acute Lymphoblastic Leukemia in Large Childhood Cancer Survivorship Cohorts.
Meng, Xiaoxi X; Chen, Cheng C; Qin, Na N; et al.
Germline analysis of 3,208 pediatric ALL (pALL) survivors versus 7,821 non‑pALL survivors and 377 non‑cancer controls evaluated ultra‑rare cancer predisposition variants (CPVs) and common variant risk. pALL survivors showed significant enrichment of ultra‑rare CPVs in BRCA1, PALB2, and PTPN11 as well as established genes CDKN2A and TP53; GWAS meta‑analysis replicated most prior risk variants and identified two novel loci (rs112425636 in SECTM1 and rs1821340 at 8q24.21), with the SECTM1 risk allele linked to reduced tumor SECTM1 expression. Median polygenic risk score was higher in pALL survivors and SNP‑based heritability was estimated at 0.19.