急性淋巴细胞白血病患儿GSTP1及MTHFR基因多态性对大剂量甲氨蝶呤不良反应的影响

发布时间：2018-03-23 08:26

本文选题：急性淋巴细胞白血病(ALL)　切入点：亚甲基四氢叶酸还原酶(MTHFR)　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:研究急性淋巴细胞白血病(ALL)患儿的GSTP1及MTHFR基因多态性对大剂量甲氨蝶呤(HDM TX)不良反应的影响。方法:对2014年1月-2016年1月98例ALL患儿采用PCR方法测定C677T A303G及MTHFR C677T的多态性,观察患儿HD-M TX化疗期间的不良反应发生情况,分析C677T及MTHFR对不良反应发生的影响。结果:98例患儿中61例(62.24%)存在有至少1个基因位点的变异;C677TA303G基因多态性表现:A基因频率84.69%,G基因频率15.31%;MTHFR C677T基因多态性表现:C基因频率66.33%,T基因频率33.67%。98例患儿中,7例(7.14%)发生骨髓抑制,23例(23.47%)发生肝损害,15例(15.31%)发生肾损害,48例(48.98%)发生胃肠道反应,46例(46.94%)发生黏膜损害。对患儿的年龄、性别、危险程度及MTX的剂量进行校正后分析显示,基因多态性与骨髓抑制、胃肠道及黏膜损害的发生无显著相关性(P0.05)。然而,变异基因数量与肝功能及肾功能损害的发生具有显著相关性(P0.05)。结论:MTHFR及C677T基因联合变异时患儿的M TX不良反应发生风险明显增加,对此应引起临床上的重视。
[Abstract]:Objective: to study the effect of GSTP1 and MTHFR gene polymorphisms on the adverse reactions of high dose methotrexate (MTX) in children with acute lymphoblastic leukemia (ALL). Methods: C677T A303G was detected by PCR in 98 children with ALL from January 2014 to January 2016. And MTHFR C677T polymorphism, Adverse reactions during HD-M TX chemotherapy in children were observed. Analysis of the influence of C677T and MTHFR on adverse reactions. Results 61 out of 98 children (62.24%) had at least one mutation of C677TA303G gene polymorphism. The expression of the gene frequency of 1% A gene was 84.6969 G gene frequency 15.31% MTHFR C677T gene polymorphism expressed as: C gene. The frequency of 66.33T gene was 33.67.98 cases (7 cases / 7.14) with bone marrow suppression (23 cases (23.47)) with liver damage (15 cases (15.31%)) with kidney damage (48 cases (48.98%)) with gastrointestinal reaction (46 cases (46.94)) with mucosal damage. Sex, risk level and dose of MTX were adjusted for analysis. There was no significant correlation between gene polymorphism and bone marrow suppression, gastrointestinal tract and mucosal damage (P 0.05). There is a significant correlation between the number of mutated genes and the occurrence of liver function and renal function damage. Conclusion the risk of MTX adverse reactions in children with combined mutation of MHFR and C677T gene is obviously increased, which should be paid more attention in clinic.
【作者单位】：西安医学院;西安唐都医院血液科;西安市儿童医院护理部;
【分类号】：R733.71

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