在泰国血性恶性瘤患者中,与毒性相关的遗传多态和临床参数,接受高剂量甲醇
Palada Pitakkitnukun1, Thanakit Pongpitakmetha2,3, Thitima Benjachat Suttichet4
1Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
Scientific reports
|April 27, 2024
概括
高剂量甲基酸盐 (HD-MTX) 化疗可能会导致脏损伤. 这项研究发现MTRR rs1801394基因变异和高MTX水平预测泰国患者的毒性. 高血压和年龄也会增加MTX水平.
科学领域:
- 药物基因组学 药物基因组学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
背景情况:
- 高剂量的甲状腺素 (HD-MTX) 对血液恶性瘤至关重要,但与急性损伤 (AKI) 等毒性相关.
- 预测和减轻HD-MTX诱导的毒性对于患者的治疗结果和治疗连续性至关重要.
- 了解患者特异性因素可以个性化HD-MTX治疗并减少不良事件.
研究的目的:
- 确定在接受HD-MTX治疗血液恶性瘤的泰国患者中毒性的预测因素.
- 探索遗传多态性和与HD-MTX相关的毒性之间的关联.
- 评估甲状腺酸盐 (MTX) 水平对结局的影响.
主要方法:
- 在80名泰国患者中对132个HD-MTX化疗周期进行了回顾性分析.
- 使用MassARRAY®系统分析了25个基因中的遗传多态性.
- 在服用后24小时和48小时监测血清肌素和MTX水平;采用多变量逻辑回归.
主要成果:
- MTRR rs1801394 (基因组A) 多态性与毒性显著相关 (OR2.084,p=0.047).
- 在24小时内MTX水平超过值的患者患毒性风险明显增加 (OR 6.818,p<0.001).
- 高血压和年龄较大是24小时MTX水平升高的独立预测因素.
结论:
- MTRR rs1801394多态性和提升的早期MTX水平是HD-MTX诱导脏毒性的显著预测因素.
- 临床因素,如高血压和年龄影响MTX水平,影响安全性.
- 这些发现支持在血液癌症患者中进行HD-MTX治疗的个性化监测和风险分层.
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