JAK2、GSTM1基因多态性与急性淋巴细胞白血病患儿化疗期间感染的关联

Association of polymorphisms of JAK2 and GSTM1 genes with infection in children with acute lymphoblastic leukemia during chemotherapy

目的探讨JAK激酶2(JAK2)、谷胱甘肽硫转移酶M1(GSTM1)基因多态性与急性淋巴细胞白血病(ALL)患儿化疗期间感染的关联。方法选取2018年5月-2021年5月中国医科大学附属盛京医院治疗的150例ALL患儿为研究对象,根据化疗期间是否并发感染分为感染组61例和非感染组89例;收集患者住院期间临床资料;采集外周静脉血,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测JAK2(rs4495487)、GSTM1基因多态性。结果感染组61例患者共培养分离病原菌65株,以革兰阴性菌株为主(72.31%,47/65)。JAK2(rs4495487)基因型(TT/TC/CC)和等位基因(T、C)频率在感染组和非感染组间均有统计学差异(P<0.05)。GSTM1非缺失型、GSTM1缺失型在感染组和非感染组间分布有统计学差异(P<0.05)。多因素Logistic回归分析提示,粒细胞缺乏时间≥7 d,JAK2(rs4495487)CC基因型及C等位基因是ALL患儿化疗期间并发医院感染的危险因素(均P<0.05)。结论JAK2(rs4495487)、GSTM1基因多态性与ALL患儿化疗期间并发医院感染相关,其中JAK2(rs4495487)CC基因型及C等位基因是并发医院感染的独立危险因素。

OBJECTIVE To explore the association of polymorphisms of JAK kinase 2(JAK2),glutathione sulfur transferase M1(GSTM1)with infection in children with acute lymphoblastic leukemia(ALL)during chemotherapy.METHODS Totally 150 children with ALL who were treated in Shengjing Hospital Affiliated to China Medical University from May 2018 to May 2021 were enrolled in the study and divided into the infection group with 61 cases and the no infection group with 89 cases according to the status of infection during chemotherapy.The clinical data of the patients during hospital stay were collected,the peripheral venous blood specimens were collected,and the gene polymorphisms of(rs4495487)and GSTM1 were detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).RESULTS A total of 65 strains of pathogens were isolated from 61 patients of the infection group,72.31%(47/65)of which were gram-negative bacteria.There were significant differences in the frequencies of(TT/TC/CC)genotypes and(T,C)alleles at JAK2(rs4495487)between the infection group and the no infection group(P<0.05).There were significant differences in the GSTM1 non-deletion type and deletion type between the infection group and the no infection group(P<0.05).Multivariate logistic regression analysis showed that duration of agranulocytosis no less than 7 days and CC genotype and C allele at JAK2(rs4495487)were the risk factors for nosocomial infection in the ALL children during chemotherapy(all P<0.05).CONCLUSION The polymorphisms of JAK2(rs4495487)and GSTM1 are associated with the nosocomial infection in the children with ALL during chemotherapy,the CC genotype and C allele at JAK2(rs4495487)are the independent risk factors for the nosocomial infection.