Relationship between NAT2 polymorphisms and onset risk of acute leukemia: a systematic review and meta-analysis

This meta-analysis aims to clarify the correlation between N-acetyltransferases 2 (NAT2) polymorphisms and susceptibility of acute leukemia.

Articles reporting the correlation between NAT2 polymorphisms and susceptibility of acute leukemia were searched from PubMed, Embase, and Cochrane. Citations in eligible articles were manually reviewed. Only cohort studies and case-control studies which provided odds ratio (OR) and 95% confidence interval (CI) of the correlation between NAT2 polymorphisms and susceptibility of acute leukemia up to December 1st, 2018 were enrolled. The included data were weighted by an inverse variance and analyzed using the fixed-effects or random-effects model. The data acquisition and the heterogeneity test were conducted. STATA 12.0 was used for statistical analysis.

This meta-analysis enrolled 10 independent case-control studies with 1,874 leukemia patients and 2,789 healthy volunteers. No significant difference was found between the fast-acetylator incidence of NAT2 haplotype and the onset risk of acute lymphoblastic leukemia (ALL, OR=0.70, 95% CI=0.45-1.08) or acute myeloid leukemia (AML, OR=0.79, 95% CI=0.46-1.47). The subgroup analysis was conducted based on the sources of controls (SOCs). We did not find statistical difference in population-based (PB) group (OR=0.82, 95% CI=0.47-1.42) and hospital-based (HB) group (OR=0.54, 95% CI=0.27-1.08). In addition, the fast-acetylator incidence of NAT2 haplotype was only observed to be higher in ALL patients compared with HB group (OR=0.52, 95% CI=0.33-0.83), rather than the PB group (OR=0.82, 95% CI=0.47-1.44).

Except for ALL patients and those hospital-based controls, no evidence has shown the relationship between NAT2 polymorphisms and the susceptibility of acute leukemia. This conclusion still needs to be further verified in multi-center hospital with a large sample size.