中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (8): 568-575.doi: 10.19401/j.cnki.1007-3639.2019.08.002

• 论著 • 上一篇    下一篇

CAR-T治疗B细胞淋巴瘤不良反应的Meta分析

康 勋 1 ,张锡友 2 ,陈  峰 1 ,李丹丹 2 ,董倩倩 2 ,宋清坤 2 ,钟晓松 2 ,李文斌 1   

  1. 1. 首都医科大学附属北京天坛医院神经肿瘤综合治疗病区,北京 100050 ;
    2. 首都医科大学附属北京世纪坛医院脑胶质瘤科,北京 100038
  • 出版日期:2019-08-30 发布日期:2019-09-29
  • 通信作者: 李文斌 E-mail: liwenbin@ccmu.com
  • 基金资助:
    国家自然科学基金(81470139);北京市科技计划“首都临床特色应用研究”专项(Z181100001718127)。

The toxicity of chimeric antigen receptor T-cell immunotherapy in B-cell lymphoma: a Meta-analysis

KANG Xun 1 , ZHANG Xiyou 2 , CHEN Feng 1 , LI Dandan 2 , DONG Qianqian 2 , SONG Qingkun 2 , ZHONG Xiaosong 2 , LI Wenbin 1   

  1. 1. Department of General Nervous Cancer Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; 2. Department of Brain Glioma, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Published:2019-08-30 Online:2019-09-29
  • Contact: LI Wenbin E-mail: liwenbin@ccmu.com

摘要: 背景与目的:复发、难治性B细胞淋巴瘤患者常规治疗方案难以奏效,研究新的治疗技术和改善预后迫在眉睫。近年来,嵌合抗原受体T细胞(chimeric antigen receptor T-cell,CAR-T)技术在B细胞淋巴瘤治疗中的突破,为复发、难治性B细胞淋巴瘤患者带来了新的希望。探讨在CAR-T技术治疗B细胞淋巴瘤的过程中,细胞因子释放综合征(cytokine release syndrome,CRS)和神经毒性等不良反应的发生率,为更加合理、安全地应用CAR-T提供理论依据。方法:检索PubMed数据库和Cochrane Library数据库的英文文献,研究从建库至2018年1月为止公开发表的CAR-T治疗B细胞淋巴瘤的10篇文献。发生率作为结局指标,按照不良反应(CRS和神经毒性)的不同,采用Meta分析汇总发生率。结果:CAR-T治疗B细胞淋巴瘤的过程中CRS的总发生率为57%(95% CI:0.25~0.90),神经毒性的总发生率为48%(95% CI:0.30~0.66)。结论:CAR-T治疗B细胞淋巴瘤的过程中CRS和神经毒性均有较高的发生率,需要引起足够重视。

关键词: 淋巴瘤, B细胞, 不良反应, Meta分析, 嵌合抗原受体T细胞, 发生率

Abstract: Background and purpose: For patients with relapsed or refractory B-cell lymphoma, conventional therapy is not effective. Researching new treatment technology to improve prognosis is imminent. Chimeric antigen receptor T-cell (CAR-T) technology has high safety and remission rate in B-cell lymphoma. The incidence rates of cytokine release syndrome (CRS) and neurological toxicity in the treatment of B-cell lymphoma with CAR-T were investigated in this study, so as to provide guidance for CAR-T in the treatment of lymphoma. Methods: Following comprehensive retrieval of PubMed database and the Cochrane Library database in English literature, a quantitative and comprehensive analysis was conducted for ten articles regarding CAR-T in the treatment of B-cell lymphoma that were published from the establishment of the databases to Jan, 2018. The incidence rate was used as the outcome. According to the difference of toxicity, Meta-analysis of the incidence rate was performed. Results: The total incidence rate of CRS in B-cell lymphoma treated with CAR-T was 57% (95% CI: 0.25-0.90), while the total incidence rate of neurological toxicity in B-cell lymphoma treated with CAR-T was 48% (95% CI: 0.30-0.66). Conclusion: The incidence rates of CRS and neurological toxicity in B-cell lymphoma treated with CAR-T are both high.

Key words: Lymphoma, B-cell, Toxicity, Meta-analysis, Chimeric antigen receptor T-cell, Incidence rate