广州医药2025，Vol.56Issue(10)：1390-1397,8.DOI:10.20223/j.cnki.1000-8535.2025.10.010
MTHFR基因多态性与成人急性淋巴细胞白血病患者大剂量甲氨蝶呤毒性反应及血药浓度关系
Relationship among MTHFR polymorphism and high dose methotrexate toxicity and blood concentration in adult patients with acute lymphoblastic leukemia
摘要
Abstract
Objective To determine the relationship among C677T and A1298C gene polymorphisms of methyltetrahydrofolate reductase(MTHFR)and adult acute lymphocytic leukemia(ALL),the relationship between the toxicity of high-dose methotrexate(HD-MTX)after chemotherapy and the MTX blood concentration of 24 h,48 h and 72 h in patients with ALL.Methods Blood samples were collected from 75 adult patients with ALL who were treated at the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2020.The samples were used to detect the genetic polymorphisms of MTHFR C677T and A1298C,and the toxic reactions were graded according to the common toxic reaction classification criteria of anti-cancer drugs.Unconditional Logistic regression was used to analyze the relationship between MTHFR C677T and A1298C gene polymorphisms and HD-MTX toxic reactions and blood drug concentration.Results The risk of anemia in MTHFR 677TT was significantly higher than that in CC type(P=0.027,OR=4.694,95%CI:1.195-18.438).No correlation was found between MTHFR C677T and leukopenia,thrombocytopenia,neutropenia,lymphogranulocytopenia,bone marrow suppression,elevated alanine aminotransferase,elevated aspartate aminotransferase,liver function injury,acute kidney injury and mucosal injury,24 h,48 h and 72 h MTX plasma concentrations(＞0.05).No correlation was found among MTHFR A1298C and HD-MTX toxicity and blood concentration(P＞0.05).Conclusions MTHFR C677T gene polymorphism is associated with hematotoxicity after HD-MTX chemotherapy in adult patients with ALL.关键词
急性淋巴细胞白血病/成人/甲氨蝶呤/亚甲基四氢叶酸还原酶/毒性反应/血药浓度Key words
acute lymphocytic leukemia/adult/methotrexate/methylene tetrahydrofolate reductase/toxicity/blood concentration引用本文复制引用
徐蕊,麦吾菊丹·阿力甫,张瑞,胡玉,孙璇,李静,陈军辉..MTHFR基因多态性与成人急性淋巴细胞白血病患者大剂量甲氨蝶呤毒性反应及血药浓度关系[J].广州医药,2025,56(10):1390-1397,8.基金项目
新疆医科大学第六附属医院临床药学重点专科基金资助项目(202401) （202401）
中华国际医学交流基金会(Z-2021-46-2101) （Z-2021-46-2101）
