系统综述:儿科急性淋巴细胞白血病患者大剂量甲氨蝶呤药代动力学中的基因多态性。

IF 2.7 4区 医学 Q3 ONCOLOGY Cancer Chemotherapy and Pharmacology Pub Date : 2024-08-01 Epub Date: 2024-07-13 DOI:10.1007/s00280-024-04694-0
Siti Utami Rahmayanti, Riezki Amalia, Taofik Rusdiana
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引用次数: 0

摘要

在治疗小儿急性淋巴细胞白血病(ALL)患者的过程中,大剂量甲氨蝶呤药代动力学反应的变化对预后和毒性管理至关重要。本系统综述旨在鉴定和评估与小儿急性淋巴细胞白血病巩固治疗阶段甲氨蝶呤药代动力学参数显著相关的基因多态性。采用系统综述首选报告项目(PRISMA)指南,我们系统地回顾了2013年至2023年的文献。使用的数据库为 PubMed 和 Scopus。我们关注的结果包括研究设计、患者特征、样本大小、采用的化疗方案、确定的药代动力学参数以及涉及的基因多态性。我们在定性综合中纳入了 31 篇文章,发现 SLCO1B1、ABCB1、ABCC2 和 MTHFR 基因似乎在 MTX 代谢和清除中起着重要作用。其中,SLCO1B1 基因变异对甲氨蝶呤清除率的影响最为显著和一致。这些基因变异可能有助于对小儿 ALL 患者进行精确的 HD-MTX 治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Systematic review: genetic polymorphisms in the pharmacokinetics of high-dose methotrexate in pediatric acute lymphoblastic leukemia patients.

Variations in pharmacokinetic responses to high-dose methotrexate are essential for the prognosis and management of toxicity in the treatment of pediatric acute lymphoblastic leukemia (ALL) patients. This systematic review aimed to identify and evaluate genetic polymorphisms that are significantly associated with the pharmacokinetic parameters of methotrexate during the consolidation phase of pediatric ALL treatment. Using the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, we systematically reviewed the literature from 2013 to 2023. The databases used were PubMed and Scopus. The outcomes of interest are the study design, patient characteristics, sample size, chemotherapy protocol utilized, pharmacokinetic parameters identified, and genetic polymorphisms implicated. We included 31 articles in the qualitative synthesis and found that the SLCO1B1, ABCB1, ABCC2, and MTHFR genes appear to play significant roles in MTX metabolism and clearance. Among these, variations in SLCO1B1 have the most significant and consistent impact on methotrexate clearance. These implicated variants may contribute to the precision and tailoring of HD-MTX treatment in pediatric ALL patients.

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来源期刊
CiteScore
6.10
自引率
3.30%
发文量
116
审稿时长
2.5 months
期刊介绍: Addressing a wide range of pharmacologic and oncologic concerns on both experimental and clinical levels, Cancer Chemotherapy and Pharmacology is an eminent journal in the field. The primary focus in this rapid publication medium is on new anticancer agents, their experimental screening, preclinical toxicology and pharmacology, single and combined drug administration modalities, and clinical phase I, II and III trials. It is essential reading for pharmacologists and oncologists giving results recorded in the following areas: clinical toxicology, pharmacokinetics, pharmacodynamics, drug interactions, and indications for chemotherapy in cancer treatment strategy.
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