Department of Medical Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, China.
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Ann Med. 2024 Dec;56(1):2427365. doi: 10.1080/07853890.2024.2427365. Epub 2024 Nov 18.
B-cell acute lymphoblastic leukaemia (B-ALL) and T-cell acute lymphoblastic leukaemia (T-ALL) are both types of acute lymphoblastic leukaemia (ALL), which is a cancer of the blood and bone marrow characterized by the rapid proliferation of immature lymphocytes. In ALL, CDKN gene deletions have been extensively studied regarding their prognostic significance. The purpose of this meta-analysis is to determine whether there is a consistent relationship between CDKN gene variations and the incidence of lymphocytic leukaemia.
The following databases contain relevant studies published between inception and 25 October 2023: PubMed, EMBASE, the Cochrane library and Web of Science were comprehensively searched. Based on the random-effects or fixed-effects model, the hazard ratio (HR) and its 95% confidence interval (95% CI) were pooled. A subgroup analysis and sensitivity analysis were also conducted. We estimated publication bias using a funnel plot.
This meta-analysis included 19 studies containing 1333 patients. Among included studies, 12 studies only reported B-ALL, four studies included patients with T-ALL and B-ALL, and three studies reported T-ALL. A deletion of the CDKN gene was found to be an adverse indicator of both EFS (HR = 1.83, 95% CI: 1.03-2.62), DFS (HR = 1.49, 95% CI 1.23-1.77), RFS (HR = 1.34, 95% CI 0.96-1.73) and OS (HR = 1.39, 95% CI 1.19-1.58). Single-arm emphasized the greater influence on OS. The subgroup analysis based on the CDKN2A, CDKN2A/b and different ALL subtypes further strengthen the validity of the findings.
Our meta-analysis revealed that CDKN gene deletions (including CDKN 2A/B, CDKN 2A) serve as adverse prognostic indicators for T-ALL/B-ALL patients.
B 细胞急性淋巴细胞白血病 (B-ALL) 和 T 细胞急性淋巴细胞白血病 (T-ALL) 均为急性淋巴细胞白血病 (ALL) 的两种类型，ALL 是一种血液和骨髓的癌症，其特征是不成熟淋巴细胞的快速增殖。在 ALL 中，CDKN 基因缺失已广泛研究其预后意义。本荟萃分析的目的是确定 CDKN 基因变异与淋巴细胞白血病发病之间是否存在一致关系。
本研究纳入了 2023 年 10 月 25 日前发表的相关研究，检索了以下数据库：PubMed、EMBASE、Cochrane 图书馆和 Web of Science。基于随机效应或固定效应模型，汇总了风险比 (HR) 及其 95%置信区间 (95%CI)。还进行了亚组分析和敏感性分析。我们使用漏斗图估计发表偏倚。
本荟萃分析纳入了 19 项研究，共纳入了 1333 名患者。纳入的研究中，有 12 项仅报告了 B-ALL，4 项研究纳入了 T-ALL 和 B-ALL 患者，3 项研究报告了 T-ALL。CDKN 基因缺失被发现是 EFS (HR=1.83, 95%CI:1.03-2.62)、DFS (HR=1.49, 95%CI 1.23-1.77)、RFS (HR=1.34, 95%CI 0.96-1.73)和 OS (HR=1.39, 95%CI 1.19-1.58)的不良预后指标。单臂研究强调了对 OS 的更大影响。基于 CDKN2A、CDKN2A/b 和不同 ALL 亚型的亚组分析进一步加强了研究结果的有效性。
本荟萃分析表明，CDKN 基因缺失（包括 CDKN2A/B、CDKN2A）是 T-ALL/B-ALL 患者不良预后的指标。
