C-MYC aberrations as prognostic factors in diffuse large B-cell lymphoma: a meta-analysis of epidemiological studies

• Published in: PloS one Vol. 9; no. 4; p. e95020
• Main Authors: Zhou, Kuangguo, Xu, Danmei, Cao, Yang, Wang, Jue, Yang, Yunfan, Huang, Mei
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.04.2014; Public Library of Science (PLoS)
• Subjects: Aberration; Abnormalities; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; B-cell lymphoma; Bias; Biology and Life Sciences; Biomarkers; c-Myc protein; Confidence intervals; Disease-Free Survival; DNA Copy Number Variations; Epidemiologic Studies; Epidemiology; Gene Amplification; Gene Rearrangement; Genes, myc - genetics; Genetic aspects; Genetic markers; Hematology; Humans; Lymphocytes B; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - genetics; Medical prognosis; Medicine and Health Sciences; Meta-analysis; Monoclonal antibodies; mRNA; Multivariate Analysis; Myc protein; Non-Hodgkin's lymphomas; Outcome Assessment (Health Care) - statistics & numerical data; Patients; Physical Sciences; Physiological aspects; Prognosis; Proportional Hazards Models; Proteins; Quality; Regression analysis; Research and Analysis Methods; Rituximab; Science; Statistical analysis; Studies; Subgroups; Survival; Survival analysis; Systematic review; Targeted cancer therapy; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0095020

Various studies have investigated the prognostic value of C-MYC aberrations in diffuse large B-cell lymphoma (DLBCL). However, the role of C-MYC as an independent prognostic factor in clinical practice remains controversial. A systematic review and meta-analysis were performed to clarify the clinical significance of C-MYC aberrations in DLBCL patients. The pooled hazard ratios (HRs) for overall survival (OS) and event-free survival (EFS) were calculated as the main effect size estimates. The procedure was conducted according to the Cochrane handbook and PRISMA guidelines, including the use of a heterogeneity test, publication bias assessment, and meta-regression, as well as subgroup analyses. Twenty-four eligible studies enrolling 4662 patients were included in this meta-analysis. According to the nature of C-MYC aberrations (gene, protein, and mRNA), studies were divided into several subgroups. For DLBCL patients with C-MYC gene abnormalities, the combined HR was 2.22 (95% confidence interval, 1.89 to 2.61) for OS and 2.29 (95% confidence interval, 1.81 to 2.90) for EFS, compared to patients without C-MYC gene abnormalities. For DLBCL patients with overexpression of C-MYC protein and C-MYC mRNA, pooled HRs for OS were 2.13 and 1.62, respectively. C-MYC aberrations appeared to play an independent role among other well-known prognostic factors in DLBCL. Addition of rituximab could not overcome the inferior prognosis conferred by C-MYC. The present systematic review and meta-analysis confirm the prognostic value of C-MYC aberrations. Screening of C-MYC should have definite prognostic meaning for DLBCL stratification, thus guaranteeing a more tailored therapy.