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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2016; 37(02): 85-89
DOI: 10.4103/0971-5851.180144
ORIGINAL ARTICLE

Effect of folate status and methylenetetrahydrofolate reductase genotypes on the complications and outcome of high dose methotrexate chemotherapy in north Indian children with acute lymphoblastic leukemia

Nirmalya Roy Moulik
Department of Pediatrics, Division of Pediatric Hematology/Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Archana Kumar
Department of Pediatrics, Division of Pediatric Hematology/Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Suraksha Agrawal
Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Abbas Ali Mahdi
Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Ashutosh Kumar
Department of Hematopathology, King George's Medical University, Lucknow, Uttar Pradesh, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Purpose: The genes of the folate metabolic pathway have been associated with toxicities during high dose methotrexate therapy for childhood ALL, however, the importance of intrinsic folate status in this regard is unclear. Methods: In the present study the effect of precourse folate levels and MTHFR genotypes on the complications during high dose methotrexate chemotherapy in children with ALL were examined. Results: Twenty-one children were studied. Folate deficiency was associated with higher incidence of neutropenia (P = 0.03) and longer duration of chemotherapy interruption (P = 0.009). Children with MTHFR1298 mutations needed more red cell transfusion (P = 0.03). All 3 deaths encountered were seen in folate deficient children. Conclusions: Folate deficiency was associated with higher complications during high dose methotrexate therapy, the implications of which are important especially in resource poor settings with high prevalence of folate deficiency.

Keywords

Childhood acute lymphoblastic leukemia - folate deficiency - high-dose methotrexate


Publication History

Article published online:
12 July 2021

© 2016. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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