巯基嘌呤甲基转移酶基因多态性与急性淋巴细胞白血病6-巯基嘌呤化疗不良反应关系的Meta分析  

Thiopurine methyltransferase polymorphisms and thiopurine toxicity in treatment of acute lymphoblastic leukemia

作　　者：刘新荣[1] 夏涛[1] 朱永生[1] 郭祥[1] 谢正南[1] 

机构地区：[1]南京医科大学第二附属医院儿童医学中心,江苏南京210003

出　　处：《南京医科大学学报（自然科学版）》2014年第9期1279-1283,共5页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的 ：探讨巯基嘌呤甲基转移酶（thiopurine methyltransferase,TPMT）基因多态性与急性淋巴细胞白血病（acute lymphoblastic leukemia,ALL）6-巯基嘌呤（6-mercaptopurine,6-MP）化疗时不良反应的关系。方法：检索ALL不同TPMT基因多态性患者6-MP化疗不良反应的人数为效应指标的相关文献,选择符合入选标准的文献,应用Stata11.0软件对研究结果进行异质性检验和效应值合并,并进行敏感性分析和偏倚评估。结果：纳入TPMT基因多态性与ALL不良反应的文献共5篇,共计病例426例。白细胞减少与TPMT基因多态性关系固定效应模型OR=4.55,95%CI：1.92~10.80;肝脏损害与TPMT基因多态性关系固定效应模型OR=2.63,95%CI：1.40~4.93。结论：TPMT基因多态性与6-MP治疗所引起的白细胞减少、肝脏损害等不良反应显著相关,更可靠的结论尚需大样本进行进一步研究。Objective：To investigate the relationship between thiopurine methyltransferase （TPMT） polymorphisms and thiopurine- induced adverse drug reactions（ADRs） in 6-macraptopurine（6-MP）of acute lymphoblastic leukemia （ALL）. Methods：Eligible articles that compared the frequency of TPMT polymorpbisms among thiopurine-tolerant and intolerant ALL patients were included. Statistical analysis was performed with STATA 11.0. Sub-analysis/sensitivity analysis and bias evaluation were also performed. Results： Five studies that investigated a total of 426 participants met our inclusion criteria. The incidence of TPMT gene mutation was increased 4.55-fold （95% CI：1.92-10.80,P = 0.001） and 2.63-fold （95% CI：1.40-4.93,P 〈 0.003）,respectively,in ALL patients with bone marrow toxicity （BMT） and thiopurine-induced hepatotoxicity,compared with controls. Conclusion：This meta-analysis suggests that the TPMT polymorphisms are associated with BMT and hepatotoxicity. We need father investigation based upen big sample to draw more realiable conclusions

关 键 词：巯基嘌呤甲基转移酶 急性淋巴细胞白血病 6-巯基嘌呤 基因多态性 META分析 

分 类 号：R733.71[医药卫生—肿瘤]