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A total of 120 genes associated with drugs used in Berlin\u2013Frankfurt\u2013M\u00fcnster protocols were selected. Variants were annotated and filtered using bioinformatic quality-control criteria, and allele frequencies were compared with African, Admixed American, East Asian, European, and South Asian populations from the 1000 Genomes Project. Multidimensional scaling was used to assess population-level genetic similarity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After quality control, 648 variants were identified. Twenty-eight variants were observed exclusively in the Indigenous study population, including four nonsynonymous coding variants with moderate predicted impact. Significant allele-frequency differences were observed for ADA rs11555566, CBR3 rs881711, and CYP2B6 rs3745274; rs881711 and rs3745274 differed from all five reference populations. Multidimensional scaling showed a distinct Indigenous pharmacogenomic profile, with greater similarity to the Admixed American population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Amazonian Indigenous populations exhibit substantial pharmacogenomic diversity in genes relevant to Berlin\u2013Frankfurt\u2013M\u00fcnster-based therapy. These findings identify candidate variants for functional and clinical validation and reinforce the importance of including underrepresented populations in pharmacogenomic research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12094-026-04562-8","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:17:23Z","timestamp":1788772643000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacogenomic diversity in Amazonian Indigenous populations: implications for Berlin\u2013Frankfurt\u2013M\u00fcnster acute lymphoblastic leukemia therapy"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1635-7288","authenticated-orcid":false,"given":"Luciana Pereira Colares","family":"Leit\u00e3o","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Monte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Carla Rodrigues","family":"Marcellino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Maur\u00edcio","family":"Ribeiro-dos-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alayde Vieira","family":"Wanderley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro Jos\u00e9","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Estefano","family":"de Santana Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c2ndrea","family":"Ribeiro-dos-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Farias","family":"Guerreiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ney Pereira Carneiro","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"4562_CR1","doi-asserted-by":"publisher","first-page":"1525751","DOI":"10.3389\/fpubh.2025.15257512","volume":"13","author":"L Wang","year":"2025","unstructured":"Wang L, Yao X, Yang L. 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