Influence of Statins on the Survival Outcomes of Patients with Diffuse Large B Cell Lymphoma: A Systematic Review and Meta-Analysis

Abstract

Background. Previous studies evaluating the influence of statins on the survival of patients with diffuse large B cell lymphoma (DLBCL) showed inconsistent results. This systematic review and meta-analysis was conducted to investigate whether statin use is correlated with the survival of DLBCL patients. Methods. Related cohort studies were obtained by searching PubMed, Embase, Cochrane’s Library, and Web of Science databases. Study characteristics and outcome data were extracted independently by two authors. The random-effect model was used for meta-analysis, considering the possible influence of between-study heterogeneity. Results. Eight studies involving 9927 patients with DLBCL were included. Results did not show significant associations of statins with overall survival (OS, hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.69∼1.11, $p=0.27$ ; I2 = 60%) or progression-free survival (PFS, HR: 0.92, 95% CI: 0.72∼1.17, $p=0.49$ ; I2 = 23%) in these patients. Subgroup analyses suggested that statin was be associated with survival of DLBCL patients from Asia (HR for OS: 1.19, 95% CI: 0.91∼1.56, $p=0.19$ , I2 = 2%; HR for PFS: 1.13, 95% CI: 0.89∼1.44, $p=0.33$ , I2 = 0%), but was associated with significantly improved survival of patients from Western countries (HR for OS: 0.73, 95% CI: 0.66∼0.81, $p<0.001$ , I2 = 0%; for PFS, HR: 0.72, 95% CI: 0.53∼0.96, $p=0.03$ , I2 = 0%), which fully explained the heterogeneity ( $p$ for subgroup difference <0.05). Variables such as study design, patient age, and study quality were not shown to affect the findings. Conclusions. Overall, statins did not affect the survival of patients with DLBCL. However, statin use may be associated with an improved survival rate of DLBCL patients from Western countries.