Objectives:
To investigate the effect of high-dose methotrexate on P-glycoprotein serum levels in pediatric patients with acute lymphocytic leukemia.
Methods:
This study was conducted using 33 pediatric patients with a confirmed diagnosis of ALL (ALL group). Patients were enrolled before receiving the HDMTX protocol. Age, body mass index, and sex ratio matched healthy pediatric subjects were included in this study (control group). Blood samples were collected from the control group at baseline, and from ALL patients at baseline and after MTX therapy, for biochemical analysis of P-glycoprotein. MTX concentration was determined in the ALL samples after treatment to correlate with P-gp serum level.
Results:
No statistically significant difference was observed in P-gp serum levels between the healthy subjects and patients with ALL before receiving MTX treatment.
P-gp serum levels were significantly lower (P <0.05) in pediatric patients with ALL after MTX treatment in all age segments compared to its levels before MTX treatment. There was no statistically significant difference in P-gp serum levels between the healthy pediatric subjects and ALL patients after MTX treatment in the first age segments (4–7 years old). However, P-gp serum levels were significantly lower in pediatric ALL patients who received MTX in both the 8–10 and the 11–14 years segments compared to the healthy group. There was no significant correlation between MTX concentration and P-gp serum level in ALL patients after MTX treatment.
Conclusion:
High-dose methotrexate may exert a downregulatory effect on P-gp serum level in ALL pediatric patients. However, this needs further investigation