The prognostic impact of long noncoding RNA HOTAIR in leukemia and lymphoma: a meta-analysis

Objectives: Multiple studies have shown that the expression level of Homeobox (HOX) transcript antisense RNA (HOTAIR) has a correlation with the diagnosis and prognosis of acute leukemia (AL) and lymphoma. The prognostic significance of HOTAIR on AL and lymphoma has been controversial. Our study thus was performed to further reveal its prognostic value in leukemia and lymphoma. Methods: By literature searching in some common electronic databases, five studies covering a number of 531 patients were included in this meta-analysis. We extracted useful data to calculate the pooled hazard ratio (HR) and p-value. Results: The combined HR estimated for overall survival (OS) was 1.87 (95% confidence interval (CI): 1.03-3.47; p = .041) when comparing patients with high HOTAIR with those low. For event/disease/relapse-free survival, the HR was 1.53 (95%CI: 0.58-4.06; p = .39). Subgroup analyses showed that the HR for OS was 2.32 (95%CI: 1.56-3.44; p = .000) in patients with AL and 1.24 (95%CI: 0.21-7.45; p = .817) in lymphoma. Additionally, the Ann-Arbor stage (p = .0009) and the international prognostic index score (p = .0065) were found to be statistically significant between patients with high and low HOTAIR expression. Also, the hemoglobin (HGB) level (p = .008), platelet (PLT) count (p = .001) and blasts in bone marrow (p = .001), but not the French-American-British classification, were found statistically significant. Discussion: Although our analysis has its limitation, it showed that high expression of HOTAIR had a significantly inferior impact on OS and some clinical parameter of leukemia and lymphoma patients. Conclusion: HOTAIR played an important prognostic role in leukemia and lymphoma and might serve as a potential target for therapeutic intervention in those patients.