Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2006-8-21
pubmed:abstractText
Methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) play key roles in intracellular folate metabolism. Polymorphisms in these enzymes have been shown to modify toxicity of methotrexate (MTX) after hematopoietic cell transplantation. In this study, we evaluated the risk of acute graft-versus-host disease (GVHD) associated with genetic variation in recipient and donor MTHFR and TS genotypes to assess whether genotype alters the efficacy of MTX in acute GVHD prophylaxis. Data on the transplantation course were abstracted from medical records for 304 adults who received allogeneic hematopoietic cell transplants. MTHFR (C677T and A1298C) and TS (enhancer-region 28-base pair repeat, TSER, and 1494del6) genotypes were determined using polymerase chain reaction/restriction fragment length polymorphism and TaqMan assays. Multivariable logistic regression was used to assess the associations between genotypes and risk of acute GVHD. Compared with recipients with the wild-type MTHFR 677CC genotype, those with the variant 677T allele showed a decreased risk of detectable acute GVHD (677CT: odds ratio, 0.8; 95% confidence interval, 0.4-1.6; 677TT: odds ratio, 0.4; 95% confidence interval, 0.2-0.8; P for trend = .01). The variant MTHFR 1298C allele in recipients was associated with an increased risk of acute GVHD compared with the wild-type MTHFR 1298AA genotype (1298AC: odds ratio, 2.0; 95% confidence interval, 1.1-3.9; 1298CC: odds ratio, 3.6; 95% confidence interval, 1.0-12.7; P for trend < .01). No association with risk of acute GVHD was observed for donor MTHFR genotypes or for recipient or donor TS genotypes, with the exception of an increase in acute GVHD among recipients whose donors had the TSER 3R/2R genotype (odds ratio, 3.0; 95% confidence interval, 1.3-7.2). These findings indicate that host, but not donor, MTHFR genotypes modify the risk of acute GVHD in recipients receiving MTX, in a manner consistent with our previously reported associations between MTHFR genotypes and MTX toxicity. A direct trade-off between drug toxicity and drug efficacy may play a role. Alternatively, the systemic folate environment, regulated by host tissues, might influence donor T-cell growth and activity.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
1083-8791
pubmed:author
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
973-80
pubmed:dateRevised
2008-11-21
pubmed:meshHeading
pubmed-meshheading:16920564-Acute Disease, pubmed-meshheading:16920564-Adolescent, pubmed-meshheading:16920564-Adult, pubmed-meshheading:16920564-Aged, pubmed-meshheading:16920564-Cohort Studies, pubmed-meshheading:16920564-Enhancer Elements, Genetic, pubmed-meshheading:16920564-Female, pubmed-meshheading:16920564-Genetic Predisposition to Disease, pubmed-meshheading:16920564-Genotype, pubmed-meshheading:16920564-Graft vs Host Disease, pubmed-meshheading:16920564-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:16920564-Humans, pubmed-meshheading:16920564-Leukemia, Myelogenous, Chronic, BCR-ABL Positive, pubmed-meshheading:16920564-Living Donors, pubmed-meshheading:16920564-Male, pubmed-meshheading:16920564-Methylenetetrahydrofolate Reductase (NADPH2), pubmed-meshheading:16920564-Microsatellite Repeats, pubmed-meshheading:16920564-Middle Aged, pubmed-meshheading:16920564-Polymorphism, Single Nucleotide, pubmed-meshheading:16920564-Predictive Value of Tests, pubmed-meshheading:16920564-Retrospective Studies, pubmed-meshheading:16920564-Risk Factors, pubmed-meshheading:16920564-Thymidylate Synthase
pubmed:year
2006
pubmed:articleTitle
Methylenetetrahydrofolate reductase and thymidylate synthase genotypes and risk of acute graft-versus-host disease following hematopoietic cell transplantation for chronic myelogenous leukemia.
pubmed:affiliation
Cancer Prevention Program, Public Health Division, University of Washington Cancer Center, Seattle, Washington, USA. robien@epi.umn.edu <robien@epi.umn.edu>
pubmed:publicationType
Journal Article, Research Support, N.I.H., Extramural