Articles written in Journal of Genetics
Volume 96 Issue 6 December 2017 pp 905-910 RESEARCH ARTICLE
Thiopurine methyltransferase (TPMT) gene polymorphism regulates thiopurine therapeutic efficacy and toxicity. The aim of this study was to determine the influence of TPMT gene polymorphism in Egyptian children with acute lymphoblastic leukaemia (ALL). Sixty-four patients with ALL, T lineage (27%) and pre-B phenotype (73%), who were treated with BFM 90 or CCG 1991 standard risk protocol, and who also experienced myleosuppresion toxicity and required interruption and/or modification of thiopurine chemotherapy were recruited over a year period. Thirty-two patients were on maintenance and another 32 completedtheir chemotherapy. Seventy healthy age-matched and sex-matched children served as controls. They were subjected to clinicalassessment, haematological panel investigations and TPMT gene polymorphism for G238C, G460A and A719G alleles assessment using PCR followed by RFLP analysis.Although none of the studied patients had themutantTPMTvariant alleles,myelosuppression toxicity in the form of different degree of neutropenia was detected in all patients. As a result of myelosuppression toxicity, most ofthe patients needed 6-MP dose modification either once (53.1%), twice (15.6%), or ≥ thrice (25.1%) during their maintenance course and 96.9% of the patients required to stop 6-MP for less than a week (62.5%), up to 2 weeks (28.1%), or > 2 weeks (6.3%). Patients also developed infection who mostly (71%) needed hospitalization. None of the studied G238C, G460A and A719G TPMT variant alleles were detected. Infections and febrile neutropenia were common causes of 6-PM dose modification and interruption.
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