Relationship between glutathione S-transferase P1 gene polymorphism and adverse drug reactions induced by cyclophosphamide: a meta-analysis

Abstract

Objective To analyze the relationship between glutathione S-transferase P1 (GSTP1) 313A>G polymorphism and the adverse reactions induced by cyclophosphamide (CP). Methods The clinical research literature about the relationship between GSTP1 313A>G polymorphism and the adverse reactions induced by CP were collected from related domestic and foreign databases up to July, 2017. The quality of the literature was evaluated by STREGA criterion. The meta-analysis was conducted by RevMan 5.2 software and the results were expressed as relative risk (RR) and 95% confidence interval (CI). Results A total of 7 articles were included in the meta-analysis and their quality evaluation results were reliable (all scores≥3), involving 1 305 patients. The results of meta-analysis showed that the differences of incidence of leukopenia, neutropenia, anemia, thrombocytopenia, myelosuppression, and infection after the treatments of CP combined with other chemotherapeutics between the patients with GSTP1 313A>G AA genotype and GSTP1 313A>G AG/GG genotype were not statistically significant (P>0.05 for all); the incidence of gastrointestinal reactions in patients with GSTP1 313A>G AA genotype was significantly lower than that in patients with GSTP1 313A>AG/GG genotype (RR=0.46, 95%CI: 0.22-0.97, P=0.004); the incidence of myelosuppression after the treatment of CP alone in patients with GSTP1 313A>G AA genotype was significantly lower than that in patients with GSTP1 313A>G AG/GG genotype (RR=0.27, 95%CI: 0.08-0.91, P=0.03). Conclusion The gastrointestinal reactions induced by CP combined with other chemotherapeutics and myelosuppression induced by CP alone may be related to the polymorphism of GSTP1 313A>G. Key words: Glutathione transferase; Cyclophosphamide; Polymorphism, genetic; Meta-analysis