甲氨蝶呤基因多态性在异基因造血干细胞移植中的研究进展

Progress on methotrexate gene polymorphisms in allogeneic hematopoietic stem cell transplantation

甲氨蝶呤(methotrexate,MTX)是用于预防造血干细胞移植后移植物抗宿主病的主要药物之一,但可引起多种不良反应,包括严重的黏膜炎、骨髓抑制、肝毒性等。目前有关MTX基因多态性的研究主要集中于大剂量MTX治疗多种癌症的疗效及并发症分析,对造血干细胞移植治疗的相关研究较少。该文从异基因造血干细胞移植角度出发,对MTX基因多态性在异基因造血干细胞移植患者的药代动力学、移植后并发症及预后中的研究进展进行了综述,以期为临床提供参考。

Methotrexate(MTX)is one of the main drugs used to prevent graft-versus-host disease(GVHD)after hematopoietic stem cell transplantation,but it can cause a variety of adverse reactions,including severe mucositis,bone marrow suppression and hepatotoxicity.Studies on MTX gene polymorphisms mainly focused on the efficacy and complications of high-dose MTX therapy for various cancers,with relatively few studies on hematopoietic stem cell transplantation.From the perspective of allogeneic hematopoietic stem cell transplantation(allo-HSCT),this article provided a comprehensive review on the pharmacokinetics,complications,and prognosis with MTX gene polymorphisms in allo-HSCT patients,in order to provide clinical reference.