A Meta-analysis Of The Efficacy And Safety Of Chimeric Antigen Receptor-T Cells In The Treatment Of Relapsed/Refractory B-cell Lymphoma

Objective: To systematically evaluate the effectiveness and safety of chimeric antigen receptor T-cell immunotherapy(CAR-T)in the treatment of relapsed/refractory B-cell lymphoma.Methods: We searched databases,including English databases such as Pub Med and Embase,and Chinese databases such as CNKI and Wanfang.The literature search period was from the establishment of the database to January2021.Retrieve the clinical research on the correlation between CAR-T and B-cell lymphoma,and use qualified clinical trials to use stata 12.0 software to conduct a meta-analysis of the effectiveness and safety of CAR-T in the treatment of B-cell lymphoma.Results: 10 studies were included in the meta-analysis,with a total sample size of 779 cases.Meta-analysis results showed./1.In terms of effectiveness: CAR-T treatment of relapsed/refractory B-cell lymphoma,the complete remission(CR)rate and total remission rate(ORR)were 51% [95% CI(44%),57%),p=0.000] and 74% [95%CI(66%,82%),p<0.01]。2.Subgroup analysis: target antigen CD19 group The ORR of the non-CD19 group was 77%(95% CI: 74%,80%),the ORR of the non-CD19 group was 71%(95% CI: 54%,88%);the ORR of the pathological type of aggressive lymphoma group was 73%(95%CI: 69%,77%),the ORR of the non-invasive lymphoma group was 79%(95%CI: 75%,83%).3.In terms of safety: the incidence of cytokine release syndrome(CRS)of grade 3 and above is 14% [95%CI(8%,20%),p<0.01].Among them,the incidence of grade 3 and above infection was 20% [95%CI(10%,29%),p<0.01];the incidence of grade 3 and above febrile neutropenia was 26%[95%% CI(16%,37%)p<0.01];the incidence of fever was 69% [95% CI(35%,103%)p<0.01].The incidence of neurotoxicity of grade 3 and above was 20% [95%CI(14%,27%),p<0.01].Conclusion: CAR-T immunotherapy has a significant effect on relapsed/refractory B-cell lymphoma.Although the incidence of adverse reactions is relatively high,most of them are controllable.The incidence of adverse reactions of grade 3 and above is relatively low,and the risk of death is small.