The effect of methylenetetrahydrofolate reductase polymorphisms on the methotrexate toxicity in children with acute lymphoblastic leukemia

Abstract

Aim: The enzyme of methylenetetrahydrofolate reductase (MTHFR) is fundamental for folate metabolism and has two common polymorphisms (C677T and A1298G). Methotrexate, which interrupts folate metabolism, is one of the backbone drugs of pediatric acute lymphoblastic leukemia (ALL). Methotrexate inhibits the synthesis of DNA replication. Material and Method: In this study, we aimed to investigate the relationship between polymorphisms of the MTHFR gene and methotrexate toxicity. 85 children with newly diagnosed ALL were enrolled in the study. MTHFR gene polymorphisms and the toxicities related to methotrexate were evaluated. Result: A total of 85 (54 females and 31 males) children were diagnosed with ALL. The allele frequencies for the FRG polymorphisms were as follows: MTHFR 677 CC 47 (55.3%), CT 29 (34.1%, TT 9 (10.6%) . No significant differences were detected with respect to event-free survival or toxicity between wild-type and other MTHFR variants. Conclusion: Clinicians must be vigilant about the pharmacogenetic features of the patients. This study reveals that personalized medicine is the next future of treating ALL.