The chemotherapy is the main means for the treatment of childhood acute lympboblastic leukemia (ALL) with a higher cure rate. As critical genes to determine the metabolism of chemotherapy drugs, CYP3A and MDR1 involye in the metabolism of many chemotherapy drugs for ALL. The single nucleotide polymorphism (SNP) of them can reduce the activity of P-glycoprotein (P-gp) and cytochrome P450 enzymes (CYPs), and further affect the effciency of drug metabolism. Nowadays an indivdual treatment is increasingly advocated, the SNPs of CYP3A and MDR1 will therefore correlate directly with the therapetic efficacy, the adverse effect of chemotherapy and the prognosis for ALL. According to the SNPs of CYP3A and MDR1, clinical manifestation and other results of the laboratory examination, ALL can be classified meticulously into three classes of standard risk, medium risk and high risk. The different chemotherapeutic protocols can be used based on the classification of ALL, which will provide a theoretical basis for the individual treatment.%儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)作为一种治愈率较高的疾病,化疗是其主要的治疗方法.CYP3A与MDR1作为决定药物代谢的关键基因,两者参与ALL化疗中大多数药物的代谢;两者基因多态性的表达会影响到药物代谢酶的活性进而影响药物代谢的效率.所以在日益提倡个体化治疗的今天,两者基因多态性的表达就直接关系到儿童ALL的治疗效果、药物毒副作用和预后.我们则可以根据两者基因多态性结合患儿的临床表现及其他实验室检查更为细致的划分出标危、中危和高危,采取不同的化疗方案,为实行个体化治疗提供理论依据.
展开▼
