Asociación de los polimorfismos genéticos de enzimas de la vía del folato y de transportadores de metotrexato con las reacciones adversas en niños con leucemia linfoblástica aguda del instituto de cáncer Solca Cuenca, Loja y Manabí

Abstract

Methotrexate (MTX) is a medication that has been used since 1948 for the treatment of various types of childhood and adult neoplasms. The appearance of adverse reactions may be associated with high doses together with chemotherapeutic agents or with the patient's genetics, since the polymorphisms of the enzymes and transporters of the folate pathway would be involved at the pharmacokinetic level of MTX, potentially affecting the bone marrow, hepatotoxicity, mucositis. , nephrotoxicity. The present study links the genetic polymorphisms of enzymes of the folate pathway and methotrexate transporters with the adverse reactions presented by children with acute lymphoblastic leukemia (ALL), the data obtained in the project “Chromosome translocations and genetic polymorphisms of enzymes” were taken. of the folate pathway and methotrexate transporters as possible predictive markers of toxicity in children with acute lymphoblastic leukemia" which includes patients aged less than or equal to 18 years diagnosed with ALL and treated at the SOLCA Hospital-Loja, Cuenca and Manabí, which are in the consolidation phase, between February 1 and August 31, 2017. The data were analyzed with descriptive statistics using the SPSS statistical program, the online program snpstats was used for the association. In the study, a total of 164 patients were evaluated, in which the polymorphisms ABCB1_rs1128504, ABCB1_rs1045643, LEP_rs7799040 and LEPR_rs1137102, CDK9_rs1544106, MTHFR_rs1801133, MTHFR_rs1801131 and CDK9_rs1544 were determined. 106 which do not correlate with the adverse reactions presented by patients treated with high doses of methotrexate.