Correlation betWeen methylenetetrahydrofolate reductase gene polymorphism and Methotrexate toxicity in pediatric acute lymphoblastic leukemia in southern Fujian / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the association between methylenetetrahydrofolate reductase( MTHFR) C677T and A1298C gene polymorphisms and toxicity of Methotrexate(MTX)chemotherapy in pediatric acute lympho-blastic leukemia(ALL). Methods From January 2015 to June 2018,128 pediatric patients with ALL in southern Fu-jian who were admitted at the First Affiliated Hospital of Xiamen University were selected. Their peripheral blood 2 mL was collected and genomic DNA was extracted. The MTHFR genotype was detected by polymerase chain reaction(PCR) direct sequencing method,and the clinical significance of HD-MTX on ALL children with toxic and side effects was evaluated according to the National Cancer Institute-Common Toxicity Criteria. Results Among 128 children,54 cases (42. 2% )presented rash,48 cases(37. 5% )with mucosal lesions,51 cases(39. 8% )with liver function damage,23 ca-ses(18. 0% )with renal function damage,52 cases(40. 6% )with gastrointestinal reactions,38 cases(29. 7% )with leu-kopenia,34 cases(26. 6% )with thrombocytopenia and 63 cases(49. 2% )with hemoglobin reduction. There was no significant difference in the incidence of MTX adverse reactions(rash,mucosa lesions,liver and renal function damage, gastrointestinal reaction,leukopenia,hemoglobin decrease and thrombocytopenia ) between the MTHFR C677T and A1298C polymorphisms(all P>0. 05). The different clinical risk(MTX dose)of the children was not statistically signi-ficant in the MTHFR C677T and A1298C genotypes and allele frequencies( χ2 =2. 573,2. 264,1. 615,0. 267;all P>0. 05). There was no significant difference among the abnormal incidence of MTX at 24 h,48 h and 72 h(all P>0. 05). Conclusions MTHFR C677T and A1298C polymorphisms do not seem to be good markers of MTX-related toxicity and/or outcome in pediatric ALL in southern Fujian,and its clinical application still needs further discussion.