Folate pathway genetic polymorphisms are related to attention disorders in childhood leukemia survivors

J Pediatr. 2008 Jan;152(1):101-5. doi: 10.1016/j.jpeds.2007.05.047. Epub 2007 Oct 24.

Abstract

Objective: To test the hypothesis that 5,10-methylenetetrahydroreductase (MTHFR) polymorphisms can partially explain the individual variation in developing attention-deficit/hyperactivity disorder (ADHD) after acute lymphoblastic leukemia (ALL) therapy.

Study design: Parents of 48 survivors of childhood ALL completed a clinical diagnostic process to identify subtypes of ADHD. Genotyping was performed with peripheral blood DNA for MTHFR (C677T and A1298C) polymorphisms.

Results: Eleven of the 48 patients (22.9%) had scores consistent with the inattentive symptoms of ADHD. Patients with genotypes related to lower folate levels (11 out of 39; 39.2%) were more likely to have ADHD. The A1298C genotype appeared to be the predominant linkage to the inattentive symptoms, leading to a 7.4-fold increase in diagnosis, compared with a 1.3-fold increase for the C677T genotype. Age at diagnosis and sex were not associated with inattentiveness.

Conclusions: Preliminary data imply a strong relationship between MTHFR polymorphisms and the inattentive symptoms of ADHD in survivors of childhood ALL.

MeSH terms

  • Adult
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / adverse effects
  • Attention Deficit Disorder with Hyperactivity / enzymology
  • Attention Deficit Disorder with Hyperactivity / genetics*
  • Child
  • Female
  • Folic Acid Antagonists / administration & dosage
  • Folic Acid Antagonists / adverse effects
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Methylenetetrahydrofolate Dehydrogenase (NAD+) / drug effects
  • Methylenetetrahydrofolate Dehydrogenase (NAD+) / genetics*
  • Parents
  • Polymorphism, Genetic* / drug effects
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Surveys and Questionnaires
  • Survivors

Substances

  • Antimetabolites, Antineoplastic
  • Folic Acid Antagonists
  • Methylenetetrahydrofolate Dehydrogenase (NAD+)
  • Methotrexate