Research article summary (published 30 Oct 2003):

Methylenetetrahydrofolate reductase gene polymorphism and glucocorticoid intake in children with ALL and aseptic osteonecrosis.

Full Abstract

BACKGROUND: Methotrexate is an essential part of the treatment of acute lymphoblastic leukaemia (ALL). Due to an increased survival of ALL patients, complications like BME (bone marrow edema) and AON (aseptic osteonecrosis) have become a matter of increasing importance. The aim of the study was to find out if a polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene predisposes to the development of BME and/or AON. Furthermore the cumulative prednisone equivalent dose per kilogram body weight was compared in a matched-pairs analysis. PATIENTS AND METHODS: A retrospective analysis of the MTHFR polymorphism of 87 patients was performed (48 male, 43 female). 14/87 patients were diagnosed with BME and/or AON (16 %). RESULTS: 42/73 patients without BME and/or AON (43 male, 34 female, median age 5.3 yrs) and 10/14 patients with BME/AON (5 male, 9 female, median age 10.2 years) presented with a MTHFR-polymorphism (p = 0.28). 14,3 % of the patients with MTHFR-polymorphism but without BME and/or AON (6/42) and 70 % of the patients with MTHFR-polymorphism and with BME and/or AON (7/10) were over 10 years of age at ALL diagnosis (p = 0.002). The mean cumulative prednisone equivalent dose per kilogram body weight was 98.0 mg, compared with 100.0 mg in the matched pairs group. CONCLUSIONS: The age of the patients at diagnosis seems to be a risk factor for the development of BME and/or AON as also seen in previous studies. If MTHFR polymorphism is an additional risk factor it was not borne out by this study, possible due to the small number of patients analyzed. This aspect is worth to be proven with a large group of patients considering the MTX pharmacokinetic and leucovorine rescue.

Author information

Author/s: Bernbeck, B (B); Mauz-Körholz, C (C); Zotz, R B (RB); Göbel, U (U);

Affiliation: Department of Paediatric Oncology, Haematology and Immunology, Heinrich Heine University Medical Center Düsseldorf, Germany. bernbeck(-atsign-)med.uni-duesseldorf.de

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

Journal: Klinische Pädiatrie (Klin Padiatr), published in Germany. (Language: eng)

Reference: -2003 Nov-Dec; vol 215 (issue 6) : pp 327-31

Dates: Created 2003/12/16; Completed 2004/04/02; Revised 2007/11/15;

PMID: 14677097, status: MEDLINE (last retrieved date: 2/18/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Adolescent Age Factors Antimetabolites, Antineoplastic - adverse effects Antineoplastic Agents, Hormonal - administration & dosage Bone Marrow Diseases - chemically induced Child Child, Preschool Data Interpretation, Statistical Edema - chemically induced Female Glucocorticoids - administration & dosage

Humans Infant Male Methotrexate - adverse effects Methylenetetrahydrofolate Reductase (NADPH2) - genetics Osteonecrosis - chemically induced Polymorphism, Genetic Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; genetics Prednisone - administration & dosage Retrospective Studies Risk Factors

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Antimetabolites, Antineoplastic (0) ; Antineoplastic Agents, Hormonal (0) ; Glucocorticoids (0) ; Prednisone (53-03-2) ; Methotrexate (59-05-2) ; Methylenetetrahydrofolate Reductase (NADPH2) (EC 1.5.1.20)

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