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

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; I(2) = 60%) or progression-free survival (PFS, HR: 0.92, 95% CI: 0.72∼1.17, p=0.49; I(2) = 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, I(2) = 2%; HR for PFS: 1.13, 95% CI: 0.89∼1.44, p=0.33, I(2) = 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, I(2) = 0%; for PFS, HR: 0.72, 95% CI: 0.53∼0.96, p=0.03, I(2) = 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.