Polymorphisms of methionine metabolism and the occurrence of white matter changes in primary central nervous system lymphoma

Aim: Methotrexate (MTX) is the most efficient cytostatic drug in primary central nervous system lymphoma (PCNSL). It directly interferes with folate and methionine metabolism: MTX inhibits methionine synthesis, which in its active form is an essential substrate for CNS myelination. A typical side effect of treatment with MTX is the occurrence of white matter changes (WMC). We aimed to analyze if polymorphisms influencing the individual methionine synthesis capacity are relevant for the occurence of WMC as a typical side effect of MTX chemotherapy. Methods: We analyzed nine polymorphisms with influence on folate…