Background
Elevated serum ferritin (SF) has been associated with poor prognosis in several malignancies. However, little is known about the relationship between SF and survival outcomes of patients with non-Hodgin lymphoma (NHL). Therefore, the present meta-analysis has investigated the prognostic value of SF in NHL patients.
Methods
A systematic search for literature evaluating the prognostic effect of SF on NHL or its subtypes was conducted on PubMed, MEDLINE, Web of Science, and Google Scholar databases. The search was limited to records authored in English and published from inception until June 2024. A random-effects model was used in pooling hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS), of which the overall estimates were presented alongside their corresponding 95% confidence interval (CI). Moreover, data presented using Kaplan Meier (KM) curves, the survival probabilities, and time intervals were retrieved using WebPlotDigitizer, after which individual patient data (IPD) was reconstructed using IPDfromKM Shiny App.
Results
Ten studies with 1384 NHL patients were eligible for inclusion. The pooled data from these studies showed that high pretreatment SF was significantly associated with poor OS (HR: 2.68; 95% CI: 2.08 - 3.47, p<0.00001). Similarly, data pooled from six included studies showed a significant correlation between elevated SF levels and poor PFS (HR: 2.25; 95% CI: 1.79 - 2.83, p<0.00001). Furthermore, the subgroup analyses showed that elevated SF was a prognostic marker for poor OS and PFS regardless of the cut-off level and NHL subtypes. However, one study carried out in Africa did not find any considerable relationship between SF and OS 2.38 (1.01 - 5.60, p = 0.00001).
Conclusion
Overall, SF might help predict the survival outcomes of patients diagnosed with different NHL subtypes. However, further research in large-scale prospective studies is needed to validate this finding.
No relevant conflicts of interest to declare.
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