The influence of MTHFR genetic polymorphisms on adverse reactions after methotrexate in patients with hematological malignancies: a meta-analysis

ABSTRACT

Objectives: The effect of methotrexate (MTX)-related adverse reaction on hematologic neoplasms patients is controversial. We performed this meta-analysis to assess the association between methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphism and the adverse reaction after MTX using.

Methods: We searched for qualified studies according to PubMed, the Cochrane Library, and the Web of Science. The meta-analysis was performed by Review Manager 5.3. The analysis was conducted to compare risk ratios (RRs) with the corresponding 95% confidence interval (95% CI) to evaluate the relationship between different toxicity reactions and the genotype of MTHFR.

Results: We included 17 studies which satisfied with the criteria in this meta-analysis. The results of our statistical analysis showed that no significant correlation between MTHFR C677T/A1298C genetic polymorphism and patients’ toxicity or the relapse and survival associated with MTX chemotherapy (P > .05). But we observed that a tendency toward increased risk of hepatotoxicity was also present for acute lymphoblastic leukemia in the mutation model (CT/TT vs. CC: RR: 1.92, 95% CI: 1.01–3.67; P = .05).

Conclusion: The polymorphism of MTHFR C677T/A1298C may not be an important indicator for the accurate detection of side effects of chemotherapy after using MTX. More relative research is needed.

KEYWORDS:

• Methylenetetrahydrofolate reductase
• genotypes
• hematologic neoplasms
• methotrexate

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Pingli Yao http://orcid.org/0000-0002-5786-7081

Additional information

Funding

This work was supported by Science and Technology Department of Sichuan Province, China (No. 14010159) for Dr Rongsheng Tong. This work was also funded by Sichuan Provincial People’s Hospital for Dr Xia He (2015QN08).