U2 small nuclear RNA auxiliary factor 1 (U2AF1) mutant is the most common molecular biological abnormality in patients with myelodysplastic syndromes. Some studies have reported the prognostic impact of U2AF1 mutant in patients with de novo MDS, with discrepant results, so we do a meta-analysis about the relevant literatures to further investigate their prognostic impact on patients with de novo MDS. We conducted a literature search on databases such as PubMed, Embase, and the Cochrane Library to obtain studies on the prognosis of U2AF1 mutant in patients with de novo MDS published up to August 9, 2018. The primary endpoint was overall survival (OS), and the secondary endpoint was acute myeloid leukemia (AML) transformation. We extracted the hazard ratios (HRs) of OS and AML transformation and their 95% confidence intervals (CIs). Meta-analysis was performed by selecting a fixed-effect model or a random-effects model based on the heterogeneity between studies. A total of 14 cohort studies were included in the final meta-analysis, including 3322 patients with de no MDS, in which 390 patients were associated with U2AF1 mutant. The results showed that U2AF1 mutant had an adverse prognostic impact on OS (HR = 1.84, 95% CI: 1.45-2.33, P < 0.00001) and AML transformation (HR = 2.47, 95% CI: 1.50-4.06, P = 0.0004). U2AF1 mutant was associated with shorter OS in subgroup analyses of low- or intermediate-1-IPSS, U2AF1S34 and U2AF1Q157/R156. Out meta-analysis indicates that U2AF1 mutants are independent, detrimental prognostic factors for OS and AML transformation in patients with de novo MDS, as well as associating with shorter OS in subgroups of low- or intermediate-1-IPSS, U2AF1S34 and U2AF1Q157/R156. Further prospective studies are needed in the future, and subgroup analysis of U2AF1 subgroups is needed to obtain a more reliable basis for the impact of U2AF1 mutant on the prognosis of de novo MDS.

中文翻译：

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U2AF1突变体在新生骨髓增生异常综合征患者中的预后价值：一项荟萃分析。

U2小核RNA辅助因子1（U2AF1）突变是骨髓增生异常综合征患者中最常见的分子生物学异常。一些研究报道了U2AF1突变体对新发MDS患者的预后影响，但结果存在差异，因此我们对相关文献进行了荟萃分析，以进一步研究其对新发MDS患者的预后影响。我们在PubMed，Embase和Cochrane库等数据库中进行了文献检索，以获取有关截至2018年8月9日发表的de novo MDS患者U2AF1突变体预后的研究。主要终点是总体生存率（OS），次要终点是急性髓细胞性白血病（AML）转化。我们提取了OS和AML转换的危险比（HR）及其95％置信区间（CI）。通过基于研究之间的异质性选择固定效应模型或随机效应模型来进行荟萃分析。最终的荟萃分析共包括14项队列研究，包括3322例无MDS的患者，其中390例与U2AF1突变体相关。结果显示U2AF1突变体对OS（HR = 1.84，95％CI：1.45-2.33，P <0.00001）和AML转化（HR = 2.47，95％CI：1.50-4.06，P = 0.0004）有不利的预后影响。在低或中级1-IPSS，U2AF1S34和U2AF1Q157 / R156的亚组分析中，U2AF1突变体与较短的OS相关。Out荟萃分析表明，U2AF1突变体是从头MDS患者中OS和AML转化的独立，有害的预后因素，并且与低或中度1 -IPSS亚组中较短的OS相关，U2AF1S34和U2AF1Q157 / R156。未来还需要进一步的前瞻性研究，还需要对U2AF1子组进行亚组分析，以便为U2AF1突变体对从头MDS预后的影响获得更可靠的依据。