Jia Ming, Wang Zhu-Jun, Zhao Hai-Zhao, Shen He-Ping, Cheng Yu-Ping, Luo Ze-Bin, Tang Yong-Min
Division of Hematology-oncology, Children's Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou, 310003, China.
World J Pediatr. 2015 May;11(2):126-33. doi: 10.1007/s12519-015-0019-1. Epub 2015 Apr 30.
Cytokine receptor-like factor 2 (CRLF2) has been shown to play a role in the pathogenesis of acute lymphoblastic leukemia (ALL). Studies have examined the relationship between CRLF2 alterations such as over-expression or deregulation and clinical outcome in childhood ALL, but the results are conflicting. This meta-analysis aimed to explore the association between CRLF2 alterations and survival of pediatric patients with ALL.
Electronic databases updated to March 2014 were searched for relevant studies. A meta-analysis was made of twelve studies including 5945 patients to evaluate the prognostic significance of CRLF2 alterations on survival in childhood ALL. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across the studies using a fixed-effects model.
CRLF2 over-expression in childhood ALL was associated with poor prognosis in terms of relapse-free survival (RFS; HR=1.70, 95% CI=1.28-2.24, P=0.000), event-free survival (EFS; HR=1.78, 95% CI=1.05-3.01, P=0.032), and overall survival (OS; HR=2.28, 95% CI=1.42-3.65, P=0.001). The combined data also suggested that CRLF2 deregulation in childhood ALL was correlated with poor EFS (HR=1.95, 95% CI=1.46-2.61, P=0.000), RFS (HR=2.20, 95% CI=1.53-3.18, P=0.000), and OS (HR=1.89, 95% CI=1.24-2.87, P=0.003). Subgroup analysis on multivariate HRs showed that CRLF2 deregulation independently predicted a poor prognosis for childhood ALL.
The present meta-analysis reveals that both CRLF2 over-expression and deregulation are associated with poor prognosis in pediatric patients with ALL.
细胞因子受体样因子2（CRLF2）已被证明在急性淋巴细胞白血病（ALL）的发病机制中起作用。研究已探讨了CRLF2改变（如过表达或失调）与儿童ALL临床结局之间的关系，但结果相互矛盾。这项荟萃分析旨在探讨CRLF2改变与小儿ALL患者生存之间的关联。
检索截至2014年3月更新的电子数据库以查找相关研究。对包括5945例患者的12项研究进行荟萃分析以评估CRLF2改变对儿童ALL生存的预后意义。使用固定效应模型汇总各研究中的风险比（HR）及95%置信区间（CI）。
儿童ALL中CRLF2过表达与无复发生存（RFS；HR = 1.70，95% CI = 1.28 - 2.24，P = 0.000）、无事件生存（EFS；HR = 1.78，95% CI = 1.05 - 3.01，P = 0.032）和总生存（OS；HR = 2.28，95% CI = 1.42 - 3.65，P = 0.001）方面的不良预后相关。合并数据还表明儿童ALL中CRLF2失调与不良EFS（HR = 1.95，95% CI = 1.46 - 2.61，P = 0.000）、RFS（HR = 2.20，95% CI = 1.53 - 3.18，P = 0.000）和OS（HR = 1.89，95% CI = 1.24 - 2.87，P = 0.003）相关。多变量HR的亚组分析表明CRLF2失调独立预测儿童ALL预后不良。
本荟萃分析表明CRLF2过表达和失调均与小儿ALL患者的不良预后相关。
