【摘要】 目的 :探讨巯基嘌呤甲基转移酶(thiopurine methyltransferase,TPMT)基因多态性与急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)6-巯基嘌呤(6-mercaptopurine,6-MP)化疗时不良反应的关系。方法:检索ALL不同TPMT基因多态性患者6-MP化疗不良反应的人数为效应指标的相关文献,选择符合入选标准的文献,应用Stata11.0软件对研究结果进行异质性检验和效应值合并,并进行敏感性分析和偏倚评估。结果:纳入TPMT基因多态性与ALL不良反应的文献共5篇,共计病例426例。白细胞减少与TPMT基因多态性关系固定效应模型OR=4.55,95%CI:1.92~10.80;肝脏损害与TPMT基因多态性关系固定效应模型OR=2.63,95%CI:1.40~4.93。结论:TPMT基因多态性与6-MP治疗所引起的白细胞减少、肝脏损害等不良反应显著相关,更可靠的结论尚需大样本进行进一步研究。更多还原

【Abstract】 Objective:To investigate the relationship between thiopurine methyltransferase(TPMT) polymorphisms and thiopurineinduced adverse drug reactions(ADRs) in 6-macraptopurine(6-MP)of acute lymphoblastic leukemia(ALL).Methods:Eligible articles that compared the frequency of TPMT polymorphisms among thiopurine-tolerant and intolerant ALL patients were included.Statistical analysis was performed with STATA 11.0.Sub-analysis / sensitivity analysis and bias evaluation were also performed.Results:Five studies that investigated a total of 426 participants met our inclusion criteria.The incidence of TPMT gene mutation was increased4.55-fold(95% CI:1.92-10.80,P = 0.001) and 2.63-fold(95% CI:1.40-4.93,P < 0.003),respectively,in ALL patients with bone marrow toxicity(BMT) and thiopurine-induced hepatotoxicity,compared with controls.Conclusion:This meta-analysis suggests that the TPMT polymorphisms are associated with BMT and hepatotoxicity.We need father investigation based upen big sample to draw more realiable conclusions更多还原