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1.中山大学肿瘤防治中心药学部,广州 510060
2.中山大学药学院,广州 510006
硕士研究生。研究方向:临床药学。E-mail:shif23@mail2.sysu.edu.cn
副主任药师,硕士生导师,博士。研究方向:药代动力学、药物基因组学。E-mail:liushu1@sysucc.org.cn
收稿日期:2025-02-17,
修回日期:2025-06-29,
录用日期:2025-06-30,
纸质出版日期:2025-07-15
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石凤,刘韬,黄河,等.非霍奇金淋巴瘤患者MS4A1基因多态性与利妥昔单抗血药浓度及疗效的相关性研究[J].中国药房,2025,36(13):1641-1647.
SHI Feng,LIU Tao,HUANG He,et al.Study on relationships of MS4A1 gene polymorphism with blood concentration and efficacy of rituximab in patients with non-Hodgkin’s lymphoma[J].ZHONGGUO YAOFANG,2025,36(13):1641-1647.
石凤,刘韬,黄河,等.非霍奇金淋巴瘤患者MS4A1基因多态性与利妥昔单抗血药浓度及疗效的相关性研究[J].中国药房,2025,36(13):1641-1647. DOI: 10.6039/j.issn.1001-0408.2025.13.15.
SHI Feng,LIU Tao,HUANG He,et al.Study on relationships of MS4A1 gene polymorphism with blood concentration and efficacy of rituximab in patients with non-Hodgkin’s lymphoma[J].ZHONGGUO YAOFANG,2025,36(13):1641-1647. DOI: 10.6039/j.issn.1001-0408.2025.13.15.
目的
2
探索非霍奇金淋巴瘤患者
MS4A1
基因多态性对利妥昔单抗血药浓度及疗效的影响。
方法
2
选择2016年1月至2020年12月在中山大学肿瘤防治中心接受R-CHOP方案的新确诊非霍奇金淋巴瘤患者160例进行前瞻性观察性研究,最短随访时间约5年。以酶联免疫吸附试验测定患者利妥昔单抗血药浓度。采用Haploview 4.2软件挑选
MS4A1
基因位点:rs1051461、rs17155034、rs4939364、rs10501385,以基质辅助激光解吸电离-飞行时间质谱法分析患者的基因型。采用单因素线性回归分析患者各因素(人口统计学、临床指标与基因型)与第1个疗程利妥昔单抗稳态谷浓度的相关性,并进行多元线性回归分析。绘制Kaplan-Meier曲线以评估患者的无进展生存期(PFS)和总生存期(OS)。以
MS4A1
基因型和肿瘤分期为自变量,采用Cox回归模型评估影响患者预后的因素。
结果
2
携带
MS4A1
rs10501385 CC基因型患者的利妥昔单抗血药浓度为15.20 μg/mL,显著低于AA+AC型患者的21.95 μg/mL(
P
<0.05)。以患者肿瘤分期和
MS4A1
rs10501385基因多态性建立的利妥昔单抗血药浓度多元线性回归模型能解释7.3%的个体差异。与携带
MS4A1
rs1051461 CC基因型患者比较,CT+TT基因型患者的PFS和OS均显著延长(
P
<0.05)。Cox回归模型显示,
MS4A1
rs1051461 CC基因型(HR=4.406,95%CI为1.743~11.137,
P
<0.05)和肿瘤分期Ⅲ或Ⅳ期(HR=3.233,95%CI为1.413~7.399,
P
<0.05)是影响患者PFS的独立危险因素。
结论
2
非霍奇金淋巴瘤患者的肿瘤分期和
MS4A1
rs10501385位点多态性是
利妥昔单抗血药浓度的关键影响因素,而肿瘤分期和
MS4A1
rs1051461位点多态性能显著影响非霍奇金淋巴瘤患者的PFS。
OBJECTIVE
2
To explore the effects of CD20 coding gene (
MS4A1
) polymorphism on the blood concentration and efficacy of rituximab in patients with non-Hodgkin’s lymphoma.
METHODS
2
A prospective observational study was conducted on 160 newly diagnosed non-Hodgkin’s lymphoma patients who received the R-CHOP regimen at the Sun Yat Sen University Cancer Center from January 2016 to December 2020, with a minimum follow-up period of approximately 5 years. The blood concentration of rituximab was detected by enzyme-linked immunosorbent assay.
MS4A1
tagSNPs were selected by Haploview4.2 software, including rs1051461, rs17155034, rs4939364, and rs10501385. The genotype of
MS4A1
was detected by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Univariate linear regression analysis was employed to examine the correlation between various factors(demographic, clinical, and genotypic variables) in patients and the steady-state trough concentration of rituximab during the first course of treatment, followed by multivariate linear regression analysis. Kaplan-Meier curves were drawn to evaluate progression-free survival (PFS) and overall survival (OS). Using
MS4A1
genotype and tumor stage as independent variables, Cox regression model was employed to evaluate the factors influencing patient prognosis.
RESULTS
2
The blood concentration of rituximab in
MS4A1
rs10501385 CC carriers was 15.20 μg/mL,which was significantly lower than 21.95 μg/mL in AA+AC carriers (
P
<0.05). The multivariate linear regression model incorporating tumor stage and
MS4A1
rs10501385 polymorphism explained 7.3% of the interindividual variability in rituximab concentrations. Compared wi
th
MS4A1
rs1051461 CC carriers, CT+TT carriers had significantly prolonged PFS and OS (
P
<0.05). The Cox proportional hazards regression model showed that the
MS4A1
rs1051461 CC genotype (HR=4.406, 95%CI:1.743-11.137,
P
<0.05) and tumor Ⅲ
&
Ⅳ (HR=3.233, 95%CI: 1.413-7.399,
P
<0.05) were independent risk factors for PFS.
CONCLUSIONS
2
The tumor staging and
MS4A1
rs10501385 polymorphism are key influencing factors for blood concentration of rituximab, and
MS4A1
rs1051461 polymorphism significantly affects PFS in non-Hodgkin’s lymphoma patients.
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