TNF-α -308 G>A polymorphism and risk of bone marrow failure syndrome: A meta-analysis.

The influence of the TNF-α −308 G>A polymorphism on bone marrow failure syndrome susceptibility is unclear. We have conducted a meta-analysis of all relevant published studies. We searched PubMed, Chinese Biomedical Literature and China National Knowledge Infrastructure databases up to February 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were applied to assess the strength of associations. Eleven case–control studies with a total sample size of 909 cases and 1803 controls were eligible to assess the association between the TNF-α −308 G>A polymorphism and susceptibility to bone marrow failure syndrome. Overall, the TNF-α −308 G>A polymorphism was significantly associated with an increased risk of bone marrow failure syndrome in any genetic model. In stratified analysis by disease type, there was a significant association between the TNF-α −308 G>A polymorphism and increased risk of aplastic anemia but no significant association with myelodysplastic syndrome (AA vs. GG: OR=2.23, 95% CI=1.23–4.05, P=0.006; recessive model: OR=3.52, 95% CI=1.30–9.53, P=0.010). In subgroup analysis by ethnicity, there were significant associations between the TNF-α −308 G>A polymorphism and increased risk of bone marrow failure syndrome for Caucasians in two models, but not in Asian populations (AA vs. GG: OR=2.66, 95% CI=1.36–5.21, P=0.003; recessive model: OR=2.68, 95% CI=1.37–5.24, P=0.002). In conclusion, our meta-analysis suggests that the TNF-α −308 G>A polymorphism may contribute to the risk of bone marrow failure syndrome, particularly among Caucasian and aplastic anemia patients. Further investigations are needed to clarify the role of the TNF-α −308 G>A polymorphism in bone marrow failure syndrome.