World Journal of Pediatrics

, Volume 11, Issue 2, pp 126–133 | Cite as

Prognostic significance of cytokine receptor-like factor 2 alterations in acute lymphoblastic leukemia: a meta-analysis

  • Ming Jia
  • Zhu-Jun Wang
  • Hai-Zhao Zhao
  • He-Ping Shen
  • Yu-Ping Cheng
  • Ze-Bin Luo
  • Yong-Min Tang



Cytokine receptor-like factor 2 (CRLF2) has been shown to play a role in the pathogenesis of acute lymphoblastic leukemia (ALL). Studies have examined the relationship between CRLF2 alterations such as over-expression or deregulation and clinical outcome in childhood ALL, but the results are conflicting. This meta-analysis aimed to explore the association between CRLF2 alterations and survival of pediatric patients with ALL.


Electronic databases updated to March 2014 were searched for relevant studies. A meta-analysis was made of twelve studies including 5945 patients to evaluate the prognostic significance of CRLF2 alterations on survival in childhood ALL. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across the studies using a fixed-effects model.


CRLF2 over-expression in childhood ALL was associated with poor prognosis in terms of relapse-free survival (RFS; HR=1.70, 95% CI=1.28–2.24, P=0.000), event-free survival (EFS; HR=1.78, 95% CI=1.05–3.01, P=0.032), and overall survival (OS; HR=2.28, 95% CI=1.42–3.65, P=0.001). The combined data also suggested that CRLF2 deregulation in childhood ALL was correlated with poor EFS (HR=1.95, 95% CI=1.46–2.61, P=0.000), RFS (HR=2.20, 95% CI=1.53–3.18, P=0.000), and OS (HR=1.89, 95% CI=1.24–2.87, P=0.003). Subgroup analysis on multivariate HRs showed that CRLF2 deregulation independently predicted a poor prognosis for childhood ALL.


The present meta-analysis reveals that both CRLF2 over-expression and deregulation are associated with poor prognosis in pediatric patients with ALL.

Key words

acute lymphoblastic leukemia cytokine receptor-like factor 2 meta-analysis prognosis 


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ming Jia
    • 1
  • Zhu-Jun Wang
    • 1
  • Hai-Zhao Zhao
    • 1
  • He-Ping Shen
    • 1
  • Yu-Ping Cheng
    • 1
  • Ze-Bin Luo
    • 1
  • Yong-Min Tang
    • 1
  1. 1.Division of Hematology-oncology, Children’s Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics (Zhejiang University)Ministry of EducationHangzhouChina

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