The challenge of p53 as prognostic and predictive factor in Hodgkin's or non-Hodgkin's lymphoma.
The results of individual studies examining the role of p53 as a predictive and prognostic factor in lymphoid malignancies have varied considerably. In order to summarize the available data on the overexpression or mutation of p53 in Hodgkin's and non-Hodgkin's lymphoma, a systematic literature review was performed. Twenty-four studies met the eligibility criteria. With respect to non-Hodgkin's lymphoma, most studies seem to support the hypothesis that patients whose tumors contain wild-type p53 respond better to treatment and have increased survival rates. If true, the implication may be that patients with p53 mutated tumors could be selected for non-standard treatment. With respect to Hodgkin's lymphoma, comparable associations were rarely reported. However, techniques for assessing the inactivation of p53 varied widely. Furthermore, in most instances, the study design and/or statistical methods did not allow sufficient analyses of the influence of confounding factors such as histologic type, stage, first-line and salvage treatment, etc. Therefore, it remains unclear whether the apparent influence of p53 status on outcome in non-Hodgkin's lymphoma is independent of established parameters such as stage, performance status, etc. Further studies involving large numbers of specimens derived from patients treated in clinical trials with identical regimens, follow-up and salvage strategies are needed. These studies should also be stratified according to histologic subtypes.
Department of Radiation Oncology, Technical University Munich, Klinikum rechts der Isar, Germany. cnied@hotmail.com
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D018572:Disease-Free Survival; D016158:Genes, p53 / Q000235:genetics; D006689:Hodgkin Disease / Q000235:genetics* / Q000401:mortality; D006801:Humans; D016393:Lymphoma, B-Cell / Q000235:genetics; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics* / Q000401:mortality; D009154:Mutation; D011379:Prognosis; D015996:Survival Rate