Pharmacogenetic analysis of liver toxicity after busulfan/cyclophosphamide-based allogeneic hematopoietic stem cell transplantation

Anticancer Res. 2007 Nov-Dec;27(6C):4377-80.

Abstract

THE AIM of this study was to evaluate the impact of genomic polymorphisms of methylene-tetrahydrofolate-reductase (MTHFR-C677T, MTHFR-A1298C) and various glutathione S-transferases (GSTP1-Ilel05Val, GSTA1*a/b, GSTM1, GSTT1) on the occurrence of liver toxicity in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT).

Patients and methods: Eighty-four adult patients were enrolled in this retrospective study. All patients were treated with busulfan/cyclophosphamide as a conditioning regimen and received cyclosporine and short-course MTX for GvHD prophylaxis. Genotyping was performed using PCR based restriction-fragment-length-polymorphism (RFLP) techniques.

Results: Multivariate analysis identified the MTHFR-A1298C polymorphism as an independent predictor for maximum levels of bilirubin (p=0.0025) and duration of hyperbilirubinaemia (p=0.013). Furthermore, there was an association between this polymorphism and the occurrence of the sinusoidal obstruction syndrome (SOS) (p=0.048). No significant associations between the MTHFR-C677T or the various GST polymorphisms and liver toxicity were observed.

Conclusion: The MTHFR-A1298C polymorphism might be associated with liver toxicity in patients receiving allogeneic HSCT.

MeSH terms

  • Adolescent
  • Adult
  • Busulfan / adverse effects*
  • Chemical and Drug Induced Liver Injury
  • Cyclophosphamide / adverse effects*
  • Female
  • Glutathione Transferase / genetics
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Liver / drug effects
  • Liver Diseases / genetics*
  • Male
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Middle Aged
  • Myeloablative Agonists / adverse effects*
  • Pharmacogenetics
  • Polymorphism, Restriction Fragment Length
  • Retrospective Studies
  • Transplantation Conditioning / adverse effects*
  • Transplantation, Homologous

Substances

  • Myeloablative Agonists
  • Cyclophosphamide
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Glutathione Transferase
  • Busulfan