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Medico Research Chronicles
By Dr. Harshit Kantilal Patel, Dr. Priyanka Rameshbhai Thakor and Dr. Vishwas Bhai Chhagan Bhai Bed.
Diffuse large B-cell lymphoma (DLBCL) is biologically heterogeneous, and about one-third of patients are not cured with rituximab-based chemoimmunotherapy.
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Following PRISMA 2020, PubMed/MEDLINE and PubMed Central were searched (2008–2025) for primary cohorts of de novo DLBCL reporting OS hazard ratios (HRs) with 95% confidence intervals (CIs) for MYC/BCL2 protein double expression (DE), TP53 mutation, tumour-cell PD-L1 expression, CD163+ M2 tumour-associated macrophages (TAMs) and non-germinal-centre B-cell (non-GCB)/activated B-cell (ABC) cell of origin (COO). The review is registered in PROSPERO (CRD420261530104).
Twenty-two studies (23 biomarker datasets; 5,522 patient observations) were included. DE was associated with inferior OS (7 studies, n = 1,749; HR 1.76, 95% CI 1.38–2.25; I² = 34%), as were TP53 mutation (3 studies, n = 795; HR 2.15, 1.59–2.92; I² = 0%) and tumour-cell PD-L1 expression (4 studies, n = 521; HR 1.96, 1.43–2.68; I² = 0%). High CD163+ TAM density predicted poor OS (2 studies, n = 487; HR 3.35, 1.33–8.43; I² = 85%).
TP53 mutation, MYC/BCL2 double expression and tumour-cell PD-L1 expression are consistent adverse prognostic biomarkers in rituximab-treated DLBCL, and M2 macrophage infiltration is a promising microenvironmental marker. COO alone adds limited prognostic information in contemporary cohorts. Keywords: Diffuse large B-cell lymphoma; MYC; BCL2; TP53; PD-L1; Tumour-associated macrophages; Cell of origin; Prognosis; Meta-analysis.
Published in Medico Research Chronicles. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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