Tianjin Medical Journal ›› 2018, Vol. 46 ›› Issue (12): 1330-1335.doi: 10.11958/20180819

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

ZHANG Xi-you,LI Dan-dan,CHEN Feng,SONG Qing-kun,ZHONG Xiao-song   

  1. 1 Department of Hematology, 2 Department of Comprehensive Treatment of Neuro-oncology, 3 Technology Department, 4 Clinical Cell and Gene Engineering Center Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2018-05-23 Revised:2018-09-02 Published:2018-12-15 Online:2019-01-24

Abstract: Objective To investigate the efficacy of chimeric antigen receptor T-cell (Car-T) in the treatment of Bcell lymphoma, and provide a theoretical basis for more rational and efficient application of Car-T therapy. Methods English literature from Pubmed database and the Cochrane library database were comprehensively retrieved. A quantitative and comprehensive analysis was conducted for eleven literatures regarding Car-T in the treatment of B-cell lymphoma that were published from the establishment of database to January 2018. The response rate was used as the indicator of outcome.The subgroup analysis was performed according to the age, pathological type, target antigen, costimulatory molecule and conditioning chemotherapy. Meta-analysis was used to summary the response rate. Results The total response rate of CarT in the treatment of B cell lymphoma was 75% (95%CI: 0.67-0.84). The combined response rates of the factors were 80%(age<65 group, 95%CI: 0.73-0.87), 88% (age≥65 group, 95%CI: 0.78-0.98), 81% (diffuse large B-cell lymphoma group,95%CI: 0.74-0.87), 79% (non diffuse large B-cell lymphoma group, 95%CI: 0.68-0.89), 77% (CD19 target antigen group,95%CI: 0.68-0.87), 69% (non CD19 target antigen group, 95%CI: 0.47-0.91), 78% (CD28 costimulatory molecule group,95%CI: 0.71-0.84), 73% (non CD28 costimulatory molecule group, 95%CI: 0.62-0.84), 78% (Cy / Flu conditioning chemotherapy group, 95%CI: 0.72-0.84), and 69% (non Cy / Flu conditioning chemotherapy group, 95%CI: 0.50-0.88)respectively. Conclusion Car-T has a high response rate on B-cell lymphoma. Subgroup analysis shows that the quite high response rates are achieved in patients with over 65 years of age, pathological type diffuse large B-cell lymphoma, target antigen CD19, costimulatory molecule CD28 and conditioning chemotherapy Cy/Flu (cyclophosphamide +fludarabine).

Key words: lymphoma, B-cell, treatment outcome, Meta-analysis, chimeric antigen receptor T cell, response rate