The Role of miRNAs as Predictors of Acute Lymphoblastic Leukemia Chemotherapy Toxicity in Children: A Systematic Review.

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, accounting for 80% of leukemias in this group and about 25% of all cancers. The 5-year survival rate is now over 90%. Achieving such a good outcome is made possible by the introduction of intensive, high-dose chemotherapy. However, it is associated with numerous complications, affecting up to 80% of patients. Among the most common of these are infections and intestinal, hepatic, hematological or neurological complications. For their effective treatment and prevention, it is necessary to develop predictors. High hopes in this aspect are placed on miRNAs. The aim of the following paper is to present the role of miRNAs as predictors of chemotherapy complications in children with ALL. Methods: A systematic review of the available literature in the PubMed, Scopus, Embase and Google Scholar scientific databases was conducted. Fourteen publications were included in the analysis. Results: Changes in miRNA expression and single-nucleotide polymorphisms in miRNAs are associated with complications of ALL therapy. Among the most notable are miR-1206 (in mucositis and myelotoxicity), miR-2053 (in neurotoxicity and mucositis), miR-938 and miR-3117 (in gastrointestinal toxicity and neurotoxicity), miR-1307 (in gastrointestinal toxicity and mucositis) and miR-323b (in gastrointestinal toxicity and myelotoxicity). In addition, miR-155, miR-3117 and miR-4268 may be potential therapeutic targets in complications of ALL therapy. Conclusions: miRNAs are good potential predictors of ALL chemotherapy toxicity and may be therapeutic targets in these complications.