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自体CD19嵌合抗原受体T细胞疗法在确诊血液系统恶性肿瘤患者中的生存结局和疗效:一项系统评价和荟萃分析

Survival outcomes and efficacy of autologous CD19 chimeric antigen receptor-T cell therapy in the patient with diagnosed hematological malignancies: a systematic review and meta-analysis.

作者信息

Drokow Emmanuel Kwateng, Ahmed Hafiz Abdul Waqas, Amponsem-Boateng Cecilia, Akpabla Gloria Selorm, Song Juanjuan, Shi Mingyue, Sun Kai

机构信息

Department of Hematology, Zhengzhou University People's Hospital & Henan Provincial People's Hospital Henan, Zhengzhou, People's Republic of China.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2019 May 6;15:637-646. doi: 10.2147/TCRM.S203822. eCollection 2019.

Abstract

Chimeric Antigen Receptor T(CAR-T) cell therapy is an immunotherapy approach used in treating cancer which has seen rapid development over the decades. It becomes the preferred treatment choice after patients have failed conventional chemotherapy. We conducted a meta-analysis in 320 patients from 14 studies to estimate the survival outcome, response rate and toxicity of autologous CD19 CAR-T cell therapy and predict other factors associated with a better prognosis. The overall response rate was 71.88% (95% CI: 61.34-80.46%, <0.01) and CRS toxicity was 60.15% (95% CI: 42.87-75.22%, <0.01). Patients who received lymphodepletion was associated with a better response rate (77%, 95%CI: 67-83%; -value =0.001) in comparison to the other patients who did not (66%, 95%CI: 41-83%). Lymphodepletion regimen may play a crucial role in predicting the prognosis of patients with hematological malignancies. Lymphodepletion patients had better progression-free survival than those who did not.

摘要

嵌合抗原受体T(CAR-T)细胞疗法是一种用于治疗癌症的免疫疗法,在过去几十年中发展迅速。在患者常规化疗失败后,它成为首选的治疗选择。我们对来自14项研究的320名患者进行了荟萃分析,以评估自体CD19 CAR-T细胞疗法的生存结果、缓解率和毒性,并预测与更好预后相关的其他因素。总体缓解率为71.88%(95%CI:61.34-80.46%,<0.01),CRS毒性为60.15%(95%CI:42.87-75.22%,<0.01)。与未接受淋巴细胞清除的其他患者(66%,95%CI:41-83%)相比,接受淋巴细胞清除的患者缓解率更高(77%,95%CI:67-83%;P值=0.001)。淋巴细胞清除方案可能在预测血液系统恶性肿瘤患者的预后中起关键作用。接受淋巴细胞清除的患者无进展生存期优于未接受的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e9b/6511615/ab0bef4cd919/TCRM-15-637-g0001.jpg

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