Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis
10.1097/CM9.0000000000000568
- Author:
Zheng XIAO-HONG
1
;
Zhang XI-YOU
;
Dong QIAN-QIAN
;
Chen FENG
;
Yang SHOU-BO
;
Li WEN-BIN
Author Information
1. Department of Neuro-Oncology
- Keywords:
Lymphoma;
B-cell;
Meta-analysis;
Chimeric antigen receptor T-cell
- From:
Chinese Medical Journal
2020;133(1):74-85
- CountryChina
- Language:Chinese
-
Abstract:
Background:Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma.Since chimeric antigen receptor Tcell (CAR-T) technology has shown high safety and results in high remission rates,we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications.Methods:We searched databases including PubMed,Embase,and Cochrane up to July 2019.Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma,measuring the response rate and complete remission rate as outcomes.Sub-group analysis was performed for age,pathological type,target antigen,co-stimulatory molecule,and conditioning chemotherapy.Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS],neurotoxicity) as an outcome.Results:Seventeen studies were included in the systematic review and meta-analysis.It was found that CAR-T cells had good therapeutic effects in the following cases:B-cell lymphoma (patients ≥65 years old);diffuse large B-cell lymphoma pathological type;patients with treatment target antigen other than CD 19;patients treated with co-stimulatory molecules other than CD28,including 4-1BB+CD28 or 4-1BB;and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy.Although the CRS and neurotoxicity incidences were high,most were reversible with minimal risk of death.Conclusion:CAR-T cell treatment is safe for clinical annlication:however,toxicity effects should be monitored.
