基因多态化与高剂量甲状腺素对骨髓瘤患者的不良反应之间的相关性:系统性审查和元分析
Ben Liu1, Gang Liu2, Binbin Liu1
1Fourth Department of Orthopedics, Cangzhou Central Hospital, No. 16 Xinhua West Road, Canal District, Cangzhou, HeBei, 061000, China.
World journal of surgical oncology
|January 11, 2024
概括
在骨髓瘤患者中,MTHFR C677T基因变异可能会增加高剂量甲状腺酸盐 (HD-MTX) 的不良反应风险. 其他基因变异与HD-MTX毒性没有显著关联.
科学领域:
- 药物基因组学 药物基因组学
- 在瘤学瘤学.
- 临床药理学 临床药理学
背景情况:
- 高剂量甲醇 (HD-MTX) 是骨髓瘤的关键化疗.
- 对HD-MTX的不良反应可以显著影响患者的结果.
- 需要个性化治疗策略来缓解这些毒性.
研究的目的:
- 为了评估特定基因多态化的影响与HD-MTX相关的不良反应在骨髓瘤患者.
- 为HD-MTX治疗中个性化药物治疗策略提供证据.
- 为了识别预测HD-MTX毒性的遗传标记.
主要方法:
- 在多个数据库中进行了系统的文献搜索,直到2023年1月.
- 对符合条件的临床研究进行了元分析和描述性分析.
- 包括的研究调查了基因多态 (MTHFR C677T,MTHFR A1298C,RFC1 G80A,MDR1 C3435T) 和HD-MTX不良反应之间的关联.
主要成果:
- 分析了12项涉及889名患者的研究.
- 在一个衰退模型下,MTHFR C677T多态性与严重的肝毒性,毒性,胃肠毒性和粘膜炎显著相关.
- 在MTHFR A1298C,RFC1 G80A,MDR1 C3435T多态和HD-MTX不良反应之间没有发现显著的相关性.
结论:
- 在骨髓瘤患者中,MTHFR C677T突变可能会增加对HD-MTX严重不良反应的风险.
- 目前的证据不支持MTHFR A1298C,RFC1 G80A或MDR1 C3435T多态和HD-MTX毒性之间的显著联系.
- 由于现有的研究数量有限,因此需要进一步研究.
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