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, =0.27;  = 60%) or progression-free survival (PFS, HR: 0.92, 95% CI: 0.72∼1.17, =0.49;  = 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, =0.19,  = 2%; HR for PFS: 1.13, 95% CI: 0.89∼1.44, =0.33,  = 0%), but was associated with significantly improved survival of patients from Western countries (HR for OS: 0.73, 95% CI: 0.66∼0.81, < 0.001,  = 0%; for PFS, HR: 0.72, 95% CI: 0.53∼0.96, =0.03,  = 0%), which fully explained the heterogeneity ( 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.