先前的研究表明,弥漫性大B细胞淋巴瘤(DLBCL)亚型同时具有B细胞抗原受体复合物相关蛋白β链(CD79B)和髓样分化原发反应88突变(MYD88)在标准免疫化疗下的预后较差。然而,CD79B在DLBCL中的预后意义尚未完全阐明.我们进行了一项荟萃分析,以研究CD79B突变对DLBCL患者总生存期(OS)的作用。
我们在PubMed和Embase数据库中进行了文献检索,并遵循PRISMA指南选择出版物进行分析。主要和次要结局分别是OS和无进展生存期(PFS)。使用Cox比例风险模型从具有个体参与者水平数据的研究中估计CD79B突变组的OS/PFS的风险比(HR),或者从具有汇总结果的原始出版物中提取。
该荟萃分析中包括9项符合CD79B突变状态的生存信息的研究。对于CD79B突变,OS的合并风险比为1.38(95%CI,1.13-1.70;p=0.0021),提供CD79B突变是影响接受免疫化疗的DLBCL患者生存的不良预后因素的证据.我们发现CD79B突变对DLBCL的预后影响较差,与已建立的预后模型无关。国际预后指数。CD79B突变的预测能力强于MYD88突变。
这项荟萃分析显示,CD79B突变可能是DLBCL疾病进展的关键生物标志物,需要研究DLBCL未来基于机制的靶向治疗。
Previous studies have shown that diffuse large B-cell lymphoma (DLBCL) subtype with both B-cell antigen receptor complex-associated protein beta chain (
CD79B) and myeloid differentiation primary response 88 mutations (MYD88) had inferior outcome under standard immunochemotherapy. However, the prognostic significance of
CD79B alone in DLBCL has not been fully elucidated. We conducted a meta-analysis to investigate the role of CD79B mutation on overall survival (OS) in patients with DLBCL.
We performed literature search in PubMed and Embase databases and followed PRISMA guidelines to select publications for analysis. The primary and secondary outcome was OS and progression-free survival (PFS) respectively. Hazard ratio (HR) for OS/PFS in CD79B mutant group with that in wild-type group in R-chemotherapy patients was either estimated using Cox proportional hazard model from the studies with individual participant level data or extracted from the original publication with aggregated results.
Nine eligible studies with survival information according to
CD79B mutation status were included in this meta-analysis. The pooled hazard ratio for OS was 1.38 (95% CI, 1.13-1.70; p = 0.0021) for
CD79B mutation, providing evidence that CD79B mutation was unfavorable prognostic factor for survival in DLBCL patients treated with immunochemotherapy. We identified the inferior prognostic impact of CD79B mutation was independent from well-established prognostic model in DLBCL, International Prognostic Index. The predictive power of
CD79B mutation was stronger than that of MYD88 mutation.
This meta-analysis revealed that CD79B mutation could be a key biomarker for DLBCL disease progression and future mechanism-based target therapy in DLBCL needs to be studied.