Efficacy and safety of CD 19-targeted CAR-T therapy for relapsed/refractory diffuse large B-cell lymphoma：a meta-analysis
- VernacularTitle:CD19靶向CAR-T治疗复发/难治性弥漫大B细胞淋巴瘤疗效和安全性的Meta分析
- Author:
Biyun LI
1
;
Yahui HAN
2
;
Chuyun YIN
1
;
Yingchao WANG
1
Author Information
1. Dept. of Pediatric Internal Medicine，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
2. Dept. of Pediatric Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
- Publication Type:Journal Article
- Keywords:
diffuse large B -cell lymphoma;
CD19
- From:
China Pharmacy
2022;33(21):2660-2665
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the efficacy and adverse reaction of CD 19-targeted chimeric antigen receptor T cells （CAR-T）in the treatment of relapsed/refractory diffuse large B -cell lymphoma （R/R DLBCL ），so as to provide an evidence -based basis for more reasonable and efficient application of CAR -T. METHODS Retrieved from PubMed ，Embase，Cochrane， ClinicalTrials.gov，CNKI，Wanfang，VIP database ，the literature about CD 19 targeted CAR -T in the treatment of R/R DLBCL that were published from the inception to April 2022 were screened . Taking objective remission rate （ORR），complete remission rate （CRR）and incidence of adverse reactions as outcome indicators ，subgroup analysis was performed according to the costimulatory factor of CAR -T and the different types of research . R 4.1.2 software was used for meta -analysis，sensitivity analysis and publication bias analysis . RESULTS A total of 11 pieces of literature were screened ，involving 1 466 patients. The ORR of CD -19 targeted CAR -T cells in the treatment of R/R DLBCL was 72.1%（95% CI：62.3%-81.9%），the CRR was 50.8%（95% CI：41.1%- 60.5%），the incidence of cytokine release syndrome （CRS）was 77.5%（95% CI：65.6%-89.4%），the incidence of neurotoxicity was 41.4%（95% CI：26.8%-56.1%）. Results of subgroup analysis showed that the incidence of ORR ，CRR，CRS and neurotoxicity in costimulatory factor CD 28 subgroup were higher than those in 4-1BB subgroup . The incidence of ORR ，CRR，CRS and neurotoxicity in the observational experimental subgroup were higher than those in the intervention experimental subgroup . CONCLUSIONS CD19 targeted CAR -T has high ORR and CRR for R/R DLBCL ，as well as higher incidence of adverse reactions. Co-stimulatory factor CD 28 has higher ORR ，CRR， CRS incidence and neurotoxicity incidence than 4-1BB.
