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MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients

Thrombosis is a well-known side effect associated with Acute Lymphoblastic Leukemia (ALL) treatment leading to significant morbidity rates. Thrombosis occurrence in ALL patients seems to be due to the interaction between the disease, the therapy and the possible inherited genetic defects affecting t...

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Main Author: Ahmed, Mohamed Nagy
Format: Thesis
Published: AUC Knowledge Fountain 2015
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access_status_str Open Access
author Ahmed, Mohamed Nagy
author_browse Ahmed, Mohamed Nagy
author_facet Ahmed, Mohamed Nagy
author_sort Ahmed, Mohamed Nagy
collection Thesis
dc_rights_str_mv The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy.
description Thrombosis is a well-known side effect associated with Acute Lymphoblastic Leukemia (ALL) treatment leading to significant morbidity rates. Thrombosis occurrence in ALL patients seems to be due to the interaction between the disease, the therapy and the possible inherited genetic defects affecting the hemostatic balance. In this study we aimed to assess the prevalence of prothrombotic defects- FV Leiden, MTHFR (Methylene Tetra Hydrofolate Reductase enzyme) C677T & prothrombin (PT) G20210A mutations in Egyptian pediatric ALL patients and its impact on the risk of thrombosis onset as well as to evaluate the impact of the presence of single versus multiple prothrombotic mutations on thrombosis. Sixty three pediatric ALL patients with thrombotic event treated with ALL protocol adopted from SJCRH (Saint Jude Cancer Research Hospital) study XV at the Children's Cancer Hospital in Egypt (CCHE) and 63 matched ALL control patients were enrolled in the study. Restriction fragment polymorphism technique was used to assess the prevalence of the FV Leiden and MTHFR C677T while Allele specific PCR was used for Prothrombin G20210A. Our results showed that MTHFR C677T prevalence between the ALL patients with and without thrombosis was 65% and 38.1% respectively p value = 0.002. The FV Leiden prevalence between the ALL patients with and without thrombosis was 17.5% and 15.9 % respectively p value= 0.81. While the prothrombin G20210A prevalence was 3.2% in both groups. In addition, patients who were older than 10 years or on SR/HR treatment protocol or in induction treatment phase were also at high risk of thrombosis. The presence of MTHFR C677T polymorphism can increase the risk of thrombosis 3 folds more than those patients who didn't have the polymorphism, while FV Leiden and PT G20210A didn't affect the thrombosis risk. Having more than one mutation didn’t show a significant effect on increasing the risk of thrombus incidence (p= 0.087). We concluded that MTHFR C677T is important risk factor for thrombosis in Egyptian pediatric ALL patients. These results may help in the prediction of the thrombosis susceptibility for ALL patients and a prophylaxis therapy may be considered before having the thrombosis. To the best of our knowledge these findings regarding the thrombosis risk factors in Egyptian pediatric ALL patients are first to be reported.
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spelling oai:fount.aucegypt.edu:etds-2176 MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients Ahmed, Mohamed Nagy Thrombosis is a well-known side effect associated with Acute Lymphoblastic Leukemia (ALL) treatment leading to significant morbidity rates. Thrombosis occurrence in ALL patients seems to be due to the interaction between the disease, the therapy and the possible inherited genetic defects affecting the hemostatic balance. In this study we aimed to assess the prevalence of prothrombotic defects- FV Leiden, MTHFR (Methylene Tetra Hydrofolate Reductase enzyme) C677T & prothrombin (PT) G20210A mutations in Egyptian pediatric ALL patients and its impact on the risk of thrombosis onset as well as to evaluate the impact of the presence of single versus multiple prothrombotic mutations on thrombosis. Sixty three pediatric ALL patients with thrombotic event treated with ALL protocol adopted from SJCRH (Saint Jude Cancer Research Hospital) study XV at the Children's Cancer Hospital in Egypt (CCHE) and 63 matched ALL control patients were enrolled in the study. Restriction fragment polymorphism technique was used to assess the prevalence of the FV Leiden and MTHFR C677T while Allele specific PCR was used for Prothrombin G20210A. Our results showed that MTHFR C677T prevalence between the ALL patients with and without thrombosis was 65% and 38.1% respectively p value = 0.002. The FV Leiden prevalence between the ALL patients with and without thrombosis was 17.5% and 15.9 % respectively p value= 0.81. While the prothrombin G20210A prevalence was 3.2% in both groups. In addition, patients who were older than 10 years or on SR/HR treatment protocol or in induction treatment phase were also at high risk of thrombosis. The presence of MTHFR C677T polymorphism can increase the risk of thrombosis 3 folds more than those patients who didn't have the polymorphism, while FV Leiden and PT G20210A didn't affect the thrombosis risk. Having more than one mutation didn’t show a significant effect on increasing the risk of thrombus incidence (p= 0.087). We concluded that MTHFR C677T is important risk factor for thrombosis in Egyptian pediatric ALL patients. These results may help in the prediction of the thrombosis susceptibility for ALL patients and a prophylaxis therapy may be considered before having the thrombosis. To the best of our knowledge these findings regarding the thrombosis risk factors in Egyptian pediatric ALL patients are first to be reported. 2015-02-01T08:00:00Z thesis application/pdf https://fount.aucegypt.edu/etds/1177 https://fount.aucegypt.edu/context/etds/article/2176/viewcontent/Mohamed_20Nagy_20Ahmed_20_20Thesis_20Final_2028_201_202015.pdf The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy. Theses and Dissertations AUC Knowledge Fountain MTHFR FV Leiden
spellingShingle MTHFR
FV Leiden
Ahmed, Mohamed Nagy
MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title_full MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title_fullStr MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title_full_unstemmed MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title_short MTHFR C677T, PT G20120A and FV Leiden as Risk Factors for Thrombosis in Egyptian Pediatric ALL Patients
title_sort mthfr c677t pt g20120a and fv leiden as risk factors for thrombosis in egyptian pediatric all patients
topic MTHFR
FV Leiden
url https://fount.aucegypt.edu/etds/1177
https://fount.aucegypt.edu/context/etds/article/2176/viewcontent/Mohamed_20Nagy_20Ahmed_20_20Thesis_20Final_2028_201_202015.pdf
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