Prognostic role of regulatory T cells in lymphoma: a systematic review and meta-analysis

J Cancer Res Clin Oncol. 2020 Dec;146(12):3123-3135. doi: 10.1007/s00432-020-03398-1. Epub 2020 Sep 29.

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: Lymphoma; Meta-analysis; Prognosis; Regulatory T cells.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / immunology
  • Hodgkin Disease / pathology
  • Humans
  • Lymphocytes / immunology
  • Lymphocytes / pathology
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / immunology
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Prognosis*
  • Progression-Free Survival
  • T-Lymphocytes, Regulatory / immunology*
  • T-Lymphocytes, Regulatory / pathology