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. I n order to summarize the available data on the overexpression or mutation o f p53 in Hodgkin's and non-Hodgkin's lymphoma, a systematic literature revi ew was performed. Twenty-four studies met the eligibility criteria. With re spect to non-Hodgkin's lymphoma, most studies seem to support the hypothesi s that patients whose tumors contain wild-type p53 respond better to treatm ent and have increased survival rates. If true, the implication may be that patients with p53 mutated tumors could be selected for non-standard treatm ent. With respect to Hodgkin's lymphoma, comparable associations were rarel y. reported. However, techniques for assessing the inactivation of p53 vari ed widely. Furthermore, in most instances, the study design and/or statisti cal methods did not allow sufficient analyses of the influence of confoundi ng 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 p arameters such as stage, performance status, etc, Further studies involving large numbers of specimens derived from patients treated in clinical trial s with identical regimens, follow-up and salvage strategies are needed. The se studies should also be stratified according to histologic subtypes.