METHODS: We enrolled consecutive IBD patients on thiopurines (azathioprine or 6-mercaptopurine) from January 2019-March 2020, at a tertiary care center in North India. The presence of the ITPA (C.94C > A) polymorphism was evaluated in all patients, along with its association with thiopurine-related leukopenia.
RESULTS: Of the 33 patients (from a total of 119 patients) that developed leukopenia, 8 had the TPMT (n = 1) or NUDT15 (n = 7) polymorphism. Of the remaining 111 patients, their mean age was 36.36 ± 13.54 years and 57 (51.3%) were males. Twenty-five (21.01%) had unexplained leukopenia. The ITPA polymorphism was detected in 4 (16%) patients in the unexplained leukopenia group and 24 (27.9%) patients in the non-leukopenia group (p = 0.228). The odds ratio for predicting leukopenia with the ITPA polymorphism was 0.4921 (95% CI 0.1520-1.5830, p = 0.234).
CONCLUSIONS: The ITPA (C.94C > A) polymorphism was frequently detected in the study population but was not predictive for leukopenia in patients with IBD on thiopurine therapy.
方法:我们从2019年1月至2020年3月在印度北部的三级护理中心招募了连续的IBD患者接受硫嘌呤(硫唑嘌呤或6-巯基嘌呤)治疗。在所有患者中评估ITPA(C.94C>A)多态性的存在,以及它与硫嘌呤相关的白细胞减少症的关系。
结果:在发生白细胞减少症的33例患者(共119例患者)中,8具有TPMT(n=1)或NUDT15(n=7)多态性。在剩下的111名患者中,他们的平均年龄为36.36±13.54岁,男性为57岁(51.3%)。25例(21.01%)患有无法解释的白细胞减少症。在无法解释的白细胞减少症组的4例(16%)患者和非白细胞减少症组的24例(27.9%)患者中检测到ITPA多态性(p=0.228)。ITPA多态性预测白细胞减少的比值比为0.4921(95%CI0.1520-1.5830,p=0.234)。
结论:在研究人群中经常检测到ITPA(C.94C>A)多态性,但不能预测接受噻嘌呤治疗的IBD患者的白细胞减少。