Prognostic role of regulatory T cells in lymphoma: a systematic review and meta-analysis
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REVIEW – CANCER RESEARCH
Prognostic role of regulatory T cells in lymphoma: a systematic review and meta‑analysis Fei Peng1 · You Qin2 · Shidai Mu1 · Jingwen Li1 · Lisha Ai1 · Yu Hu1,3 Received: 22 July 2020 / Accepted: 16 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The regulatory T cells (Tregs) are a subpopulation of lymphocytes that suppress the immune responses. The prognostic value of Tregs in lymphoma patients remains controversial. Thus, we conducted this meta-analysis to clarify the role of Tregs in the prognosis of lymphoma patients. Methods We searched PubMed, Embase, and Web of Science to obtain eligible studies that evaluated the prognostic factor of Tregs for lymphoma patients. Hazards ratios (HRs) with the matching 95% confidence intervals (95%CIs) were merged to estimate the prognostic value of Tregs. Results We finally retrieved 23 eligible studies, including a total of 2269 patients. The overall pooled analysis on all types of lymphomas showed that Tregs had a significantly positive association with prolonged overall survival (OS) (HR = 0.633, 95% CI 0.528–0.758) and progression-free survival (PFS) (HR = 0.451, 95% CI 0.261–0.779). Subgroup analysis indicated that high Tregs were significantly correlated with longer OS in Hodgkin lymphoma, diffuse large B cell lymphoma, and natural killer/T cell lymphoma. However, there was no significant association of Tregs with T cell lymphoma and follicular lymphoma. Conclusions Increased Tregs indicates a better prognosis for patients with lymphoma. Tregs could be used as a valuable prognostic biomarker of lymphoma patients. Keywords Regulatory T cells · Lymphoma · Prognosis · Meta-analysis Abbreviations Tregs Regulatory T cells HR Hazards ratio CI Confidence interval OS Overall survival PFS Progression-free survival Fei Peng and You Qin contributed equally to this work. * Lisha Ai [email protected] * Yu Hu [email protected] 1
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei, China
2
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
3
Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan 430022, China
NHL Non-Hodgkin lymphoma HL Hodgkin lymphoma MDSCs Myeloid-derived suppressor cells FOXP3 Forkhead box P3 NOS Newcastle–Ottawa Quality Assessment Scale BCL B-cell lymphoma NKTCL Natural killer/T cell lymphoma TCL T cell lymphoma FL Follicular lymphoma DLBCL Diffuse large B cell lymphoma IPI International prognostic index Th cells T helper cells CTLs Cytotoxic T cells DCs Dendritic cells T cons Conventional T cells cAMP Cyclic adenosine monophosphate IL-10 Interleukin-10 NK cells Natural killer cells RS cells Reed-Sternberg cells Tfh T follicular helper cells IL-2 Interleukin-2
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Introduction Lymphoma is a neoplasia of the
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