Ras gene mutation in acute myeloid leukemia and Myelodysplastic syndromes: a meta-analysis of its occurrence and prognostic relevance

Abstract

Objective: The literature remains controversial on ras gene mutation prognostic significance for survival in AML and MDS. In this paper, study meta-analysis of its occurrence and prognostic relevance in acute myeloid leukemia and Myelodysplastic syndromes. Methods: The PubMed, Cochrane Library, EBSCO, and EMBASE databases were systematically searched for reports published from 1990 to 2015. Two authors independently assessed the methodological quality and the extracted data. The Hazard ratios and adjusted hazard ratios (HRs), a sensitivity analysis, and the publication bias were analyzed using the CMA v2 (Comprehensive Meta Analysis Version 2) software program. Results: Combined HRs suggested that an abnormal ras status had a different impact on survival: in AML group the HRs was 1.10 (0.97-1.26, p=0.15), was 1.89 (95% CI, 1.56-2.30, p<0.001) in MDS group. Further subtype of ras analysis, the pooled HRs in AML and MDS harbored Nras mutations were 1.34 (1.09-1.65, p= 0.006) and 2.01 (1.52-2.66, p<0.001), respectively. The pooled HRs was 2.16 (1.13-4.10, p= 0.02) in AML patients with Kras. Conclusions: Take no account of the type of ras, the study found ras gene mutations seem not to correlate with the prognosis of patients with AML, however, further research subtype of ras, there was a poor prognosis in AML and MDS patients with Nras and AML patients with Kras. The association remains to be confirmed with a more precise analysis of a large sample and more studies should be focus on studying the prognosis between AML and MDS patients and the subtype of ras even special codon mutation.