Lin Yun, Fang Zhihong, Lin Zhijuan, Li Zhifeng, Zhao Jintao, Luo Yiming, Xu Bing
a Department of Hematology , The First Affiliated Hospital of Xiamen University , Xiamen , People's Republic of China.
Hematology. 2018 Oct;23(9):600-607. doi: 10.1080/10245332.2018.1446572. Epub 2018 Mar 7.
Multiple studies have shown that the expression level of Homeobox (HOX) transcript antisense RNA (HOTAIR) has a correlation with the diagnosis and prognosis of acute leukemia (AL) and lymphoma. The prognostic significance of HOTAIR on AL and lymphoma has been controversial. Our study thus was performed to further reveal its prognostic value in leukemia and lymphoma.
By literature searching in some common electronic databases, five studies covering a number of 531 patients were included in this meta-analysis. We extracted useful data to calculate the pooled hazard ratio (HR) and p-value.
The combined HR estimated for overall survival (OS) was 1.87 (95% confidence interval (CI): 1.03-3.47; p = .041) when comparing patients with high HOTAIR with those low. For event/disease/relapse-free survival, the HR was 1.53 (95%CI: 0.58-4.06; p = .39). Subgroup analyses showed that the HR for OS was 2.32 (95%CI: 1.56-3.44; p = .000) in patients with AL and 1.24 (95%CI: 0.21-7.45; p = .817) in lymphoma. Additionally, the Ann-Arbor stage (p = .0009) and the international prognostic index score (p = .0065) were found to be statistically significant between patients with high and low HOTAIR expression. Also, the hemoglobin (HGB) level (p = .008), platelet (PLT) count (p = .001) and blasts in bone marrow (p = .001), but not the French-American-British classification, were found statistically significant.
Although our analysis has its limitation, it showed that high expression of HOTAIR had a significantly inferior impact on OS and some clinical parameter of leukemia and lymphoma patients.
HOTAIR played an important prognostic role in leukemia and lymphoma and might serve as a potential target for therapeutic intervention in those patients.
多项研究表明,同源框(HOX)转录反义RNA(HOTAIR)的表达水平与急性白血病(AL)和淋巴瘤的诊断及预后相关。HOTAIR对AL和淋巴瘤的预后意义一直存在争议。因此,我们开展本研究以进一步揭示其在白血病和淋巴瘤中的预后价值。
通过在一些常见电子数据库中进行文献检索,本荟萃分析纳入了5项涵盖531例患者的研究。我们提取有用数据以计算合并风险比(HR)和p值。
将HOTAIR高表达患者与低表达患者进行比较时,总体生存(OS)的合并HR估计值为1.87(95%置信区间(CI):1.03 - 3.47;p = 0.041)。对于无事件/疾病/复发生存,HR为1.53(95%CI:0.58 - 4.06;p = 0.39)。亚组分析显示,AL患者的OS的HR为2.32(95%CI:1.56 - 3.44;p = 0.000),淋巴瘤患者为1.24(95%CI:0.21 - 7.45;p = 0.817)。此外,发现Ann-Arbor分期(p = 0.0009)和国际预后指数评分(p = 0.0065)在HOTAIR高表达和低表达患者之间具有统计学意义。同样,血红蛋白(HGB)水平(p = 0.008)、血小板(PLT)计数(p = 0.001)和骨髓原始细胞(p = 0.001)具有统计学意义,但法国-美国-英国分类无统计学意义。
尽管我们的分析存在局限性,但结果显示HOTAIR高表达对白血病和淋巴瘤患者的OS及一些临床参数有显著较差的影响。
HOTAIR在白血病和淋巴瘤中发挥重要的预后作用,可能是这些患者治疗干预的潜在靶点。