急性淋巴细胞白血病患儿MTHFR C677T基因多态性与大剂量甲氨蝶呤治疗后肝功能异常的相关性

doi:10.3969/j.issn.2095-9400.2020.09.013

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Abstract Objective: To investigate the correlation between MTHFR C677T gene polymorphism and abnormal liver function in pediatric acute lymphoblastic leukemia (ALL) after treatment with high-dose methotrexate (HD-MTX). Methods: The clinical data of 66 children with ALL treated with HD-MTX in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from October 2017 to March 2020 were analyzed retrospectively. According to the genotype of MTHFR C677T, the children were divided into wild group (CC) and mutant group (CT+TT) to compare differences in incidence of toxicity, liver function indexes PA, ALT, AST, AST/ALT, TP, ALB, LDH, GGT, TBIL, CHE and blood drug concentrations at 48 h and 72 h after HD-MTX treatment. Results: Compared with the wild group, MTHFR C677T mutation group had a higher incidence of abnormal liver function (P<0.05), in which the proportion of children with abnormal levels of AST, ALT and CHE increased significantly (P<0.05), but there was no significant difference in other liver function indexes (P>0.05). Further analysis of the difference in HD-MTX concentrations between different genotypes showed that the mutant type, compared with the wild type, had higher blood drug concentrations at 48 h and 72 h (P<0.05). Conclusion: The proportion with abnormal levels of serum AST, ALT and CHE is higher for children with MTHFR C677T mutation type after treatment with HD-MTX, and detection of MTHFR C677T genotype has clinical application value in predicting abnormal liver function after HD-MTX treatment.

Key words： methylenetetrahydrofolate reductase single nucleotide polymorphism acute lymphocytic leukemia liver function blood drug level

Received: 06 May 2020

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	LIU Linna
	LI Tao
	GE Hanyu
	CHEN Zhanguo
	Yu Jian
	ZHENG Xiaoqun.

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2020.09.013 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I9/753

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