嵌合抗原受体 T 细胞抗 CD19 治疗 B 细胞恶性肿瘤的疗效。
The efficacy of anti-CD19 chimeric antigen receptor T cells for B-cell malignancies.
机构信息
Biotherapy Center, The Seventh Medical Center of PLA General Hospital, Beijing, China.
Biotherapy Center, The Seventh Medical Center of PLA General Hospital, Beijing, China.
出版信息
Cytotherapy. 2019 Jul;21(7):769-781. doi: 10.1016/j.jcyt.2019.04.005. Epub 2019 May 31.
Immunotherapy with chimeric antigen receptor T (CAR-T) cells has proved remarkably effective in recently published clinical trials. In this meta-analysis, we performed a systematic review in terms of the clinical response treated with CAR-T cells in acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL) and lymphomas patients. Thirty-eight published clinical studies including 665 patients were eligible for response rate (RR) evaluation. The overall pooled RR of CD19-CAR-T cells was 72% (95% confidence interval: 62-77%). The various clinical parameters were analyzed. RR was 81% in ALL, 68% in lymphoma and 70% in CLL. RR in patients who received interleukin (IL)-2 was 70%, whereas in those who did not receive IL-2, it was 74%. RR was 75% with lymphodepletion and 56% without lymphodepletion. RR with autologous cells was 76% and 57% with allogeneic cells. In conclusion, this meta-analysis showed a high clinical RR of CD19-CAR-T cell-based immunotherapy in patients with refractory B-cell malignancies.
嵌合抗原受体 T (CAR-T) 细胞的免疫疗法在最近发表的临床试验中被证明具有显著疗效。在这项荟萃分析中，我们针对 CAR-T 细胞治疗急性淋巴细胞白血病 (ALL)、慢性淋巴细胞白血病 (CLL) 和淋巴瘤患者的临床反应进行了系统评价。38 项已发表的临床研究共纳入 665 例患者，适合进行缓解率 (RR) 评估。CD19-CAR-T 细胞的总体汇总 RR 为 72% (95%置信区间：62-77%)。分析了各种临床参数。ALL 的 RR 为 81%，淋巴瘤为 68%，CLL 为 70%。接受白细胞介素 (IL)-2 治疗的患者 RR 为 70%，而未接受 IL-2 治疗的患者 RR 为 74%。淋巴耗竭的 RR 为 75%，无淋巴耗竭的 RR 为 56%。自体细胞的 RR 为 76%，异基因细胞的 RR 为 57%。总之，这项荟萃分析表明，基于 CD19-CAR-T 细胞的免疫疗法在难治性 B 细胞恶性肿瘤患者中具有较高的临床 RR。
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