Association between ABCB1 C3435 T polymorphism- and methotrexate-related toxicity in pediatric acute lymphoblastic leukemia: a meta-analysis.
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BACKGROUND: The effect of methotrexate (MTX)-related toxicity on childhood acute lymphoblastic leukemia (ALL) is controversial. Hence, this meta-analysis aimed to investigate the association between ABCB1 C3435 T polymorphism- and methotrexate-related toxicity in pediatric acute lymphoblastic leukemia. METHODS: Relevant studies were systematically searched and extracted from multiple databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases up to 1 June, 2024. RESULTS: A total of 13 articles met the criteria, including 1506 patients. The results showed that ABCB1 C3435 T polymorphism was significantly associated with MTX-induced hepatotoxicity (CT/TT vs. CC: OR: 2.15, 95% CI: 1.40-3.32). There was no significant difference between ABCB1 C3435 T polymorphism and mucositis, myelosuppression, nephrotoxicity, gastrointestinal toxicity in pediatric ALL treated with MTX. CONCLUSIONS: Our meta-analysis suggests that the ABCB1 C3435 T mutation may enhance the MTX-induced hepatotoxicity in childhood acute lymphoblastic leukemia.