Abstract
BACKGROUND: Vascular endothelial growth factor-A (VEGF-A), In combination with other pro-angiogenic factors, plays a pivotal role in angiogenesis and the pathogenesis of acute lymphoblastic leukemia (ALL). AIMS: This meta-analysis aims to evaluate the diagnostic value of VEGF-A and its prognostic relevance in the outcome of patients with ALL. METHODS AND RESULTS: A comprehensive literature search was conducted up to January 2025 across multiple databases. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using a random-effects model to quantify effect sizes. Subgroup analyses and meta-regression were employed to explore heterogeneity sources. Data extracted from 15 studies encompassing 674 patients with ALL demonstrated a significant correlation between elevated VEGF-A levels and unfavorable prognosis (SMD: 0.878; 95% CI: 0.276-1.479; p = 0.004). Notably, increased VEGF-A levels were particularly evident in pediatric patients older than 8 years (SMD: 0.758; 95% CI: 0.178-1.338; p = 0.010). CONCLUSION: The results indicate that heightened VEGF-A expression is associated with poorer clinical outcomes in ALL, supporting its utility as a diagnostic and prognostic biomarker in this patient population.