CAJ | 학술논문

目的：探讨SLC19A1基因多态性与大剂量甲氨蝶呤化疗后急性白血病及恶性淋巴瘤骨髓抑制及感染的相关性。方法治疗方案用CALLG2008方案、Hyper-CVAD方案及BFM90方案，提取基因组DNA，聚合酶链式反应-限制性片段长度多态性技术（PCR-RFLP）分析SLC19A1 A80G多态性。监测患者大剂量甲氨蝶呤化疗期间的外周血细胞计数，分析SLC19 A1基因多态性与大剂量甲氨蝶呤化疗后骨髓抑制及粒细胞缺乏合并感染的关系。结果共纳入45例急性淋巴细胞白血病患者，10例恶性淋巴瘤患者，研究人群中SLC19A1 AA、AG、GG基因型分别占16.36％，60.00％和23.64％；发生Ⅲ级以上骨髓抑制的AA型患者1例（11.11％），AG型10例（30.30％），GG型3例（23.08％）。各基因型与大剂量甲氨蝶呤化疗后发生Ⅲ级以上骨髓抑制无明显相关性；化疗后有25例轻度粒细胞缺乏，7例重度粒细胞缺乏，2例轻度粒细胞缺乏合并感染，其中GG基因型在发生轻度粒细胞缺乏合并感染患者中频率最高（ P＜0.05）。结论 SLC19A1遗传多态性可能成为预测大剂量甲氨蝶呤化疗不良反应的有效遗传学标记。
목적：탐토SLC19A1기인다태성여대제량갑안접령화료후급성백혈병급악성림파류골수억제급감염적상관성。방법치료방안용CALLG2008방안、Hyper-CVAD방안급BFM90방안，제취기인조DNA，취합매련식반응-한제성편단장도다태성기술（PCR-RFLP）분석SLC19A1 A80G다태성。감측환자대제량갑안접령화료기간적외주혈세포계수，분석SLC19 A1기인다태성여대제량갑안접령화료후골수억제급립세포결핍합병감염적관계。결과공납입45례급성림파세포백혈병환자，10례악성림파류환자，연구인군중SLC19A1 AA、AG、GG기인형분별점16.36％，60.00％화23.64％；발생Ⅲ급이상골수억제적AA형환자1례（11.11％），AG형10례（30.30％），GG형3례（23.08％）。각기인형여대제량갑안접령화료후발생Ⅲ급이상골수억제무명현상관성；화료후유25례경도립세포결핍，7례중도립세포결핍，2례경도립세포결핍합병감염，기중GG기인형재발생경도립세포결핍합병감염환자중빈솔최고（ P＜0.05）。결론 SLC19A1유전다태성가능성위예측대제량갑안접령화료불량반응적유효유전학표기。
Objective To research the association between gene polymorphism of SLC19A1 and myelosuppression induced febrile neutro-penia after high -dose methotrexate. Methods The CALLG2008, Hyper-CVAD and BFM90 regimens were adopted .The Kit assay was used to extract DNA by blood samples , and the polymorphism of SLC19 A1 A80 G was detected by PCR -restriction fragment length polymorphism ( PCR-RFLP ) .The data of peripheral blood cell count with high -dose methotrexate chemotherapy were monitored , and the relationship between SLC19A1 gene polymorphism and bone marrow suppression induced febrile neutropenia was analyzed .Results There were 45 patients with acute lymphoblastic leukemia and 10 patients with malignant lymphoma included in the study . It was found that the frequency of SLC19A1 A80G was 16.36%(AA), 60.00%(AG), and 23.64% ( GG ) . The incidence of Ⅲ myelosuppression showed association of 11.11% in AA genotype , 30.30% in AG genotype and 23.08%in GG genotype , therefore, there was no significant difference in the three genotypes of SLC 19 A1 A80 G and myelosuppression .There were 25 cases of mild neutropenia after chemotherapy , 7 cases of severe neutropenia and 2 cases of febrile neutropenia co-infection.According to the study, patients with the GG genotype in SLC19A1 showed a greater occurrence of febrile neutropenia co-infection than other types ( P <0.05 ) .Conclusion The genotype of SLC19A1 may be an effective genetic marker to predict HD-MTX induced toxic reaction .