- de Smith, Adam J;
- Wahlster, Lara;
- Jeon, Soyoung;
- Kachuri, Linda;
- Black, Susan;
- Langie, Jalen;
- Cato, Liam D;
- Nakatsuka, Nathan;
- Chan, Tsz-Fung;
- Xia, Guangze;
- Mazumder, Soumyaa;
- Yang, Wenjian;
- Gazal, Steven;
- Eng, Celeste;
- Hu, Donglei;
- Burchard, Esteban González;
- Ziv, Elad;
- Metayer, Catherine;
- Mancuso, Nicholas;
- Yang, Jun J;
- Ma, Xiaomei;
- Wiemels, Joseph L;
- Yu, Fulong;
- Chiang, Charleston WK;
- Sankaran, Vijay G
Hispanic/Latino children have the highest risk of acute lymphoblastic leukemia (ALL) in the US compared to other racial/ethnic groups, yet the basis of this remains incompletely understood. Through genetic fine-mapping analyses, we identified a new independent childhood ALL risk signal near IKZF1 in self-reported Hispanic/Latino individuals, but not in non-Hispanic White individuals, with an effect size of ∼1.44 (95% confidence interval = 1.33-1.55) and a risk allele frequency of ∼18% in Hispanic/Latino populations and <0.5% in European populations. This risk allele was positively associated with Indigenous American ancestry, showed evidence of selection in human history, and was associated with reduced IKZF1 expression. We identified a putative causal variant in a downstream enhancer that is most active in pro-B cells and interacts with the IKZF1 promoter. This variant disrupts IKZF1 autoregulation at this enhancer and results in reduced enhancer activity in B cell progenitors. Our study reveals a genetic basis for the increased ALL risk in Hispanic/Latino children.