The Efficacy Of Rituximab With Conventional Chemotherapy In Mantle Cell Lymphoma:A Systematic Review

Objective:To assess the clinical efficacy of rituximab combined with conventional chemotherapy treatment mantle cell lymphoma through systemic review.Methods: We searched Pubmed 、 Elsevier 、 EMBASE 、 Cochrane Library、 CBM、 CNKI、 VIP、 Wanfang database,combined with handsearched and additional retrieval; retrieved the years from 1991 to2016,the language was limited to English or Chinese, Randomized controlled trials of rituximab combined with conventional chemotherapy therapy in mantle cell lymphoma were included, extracted the relevant information and data. Evaluation of outcome indices included ORR,CRR,PD,OS, PFS, and observed the adverse reactions. Used Rev Man 5.3software and stata12.0 to statistical analyse the data, the relative risk for binary data was estimated and hazard ratios for time-to-event data was also.Result: A total of six randomized controlled trials were identified including 692 patients with mantle cell lymphoma. The results of meta analysis were listed as follows: Patients treated with rituximab combined with conventional chemotherapy had statistically significantly betterORR[ RR= 1.19, 95%CI(1.08-1.31), p= 0.0005]、CRR[ RR=2.81, 95%CI(1.20-6.59),p = 0.02]、OS[HR= 0.73, 95% CI(0.56-0.94),p=0.01]、PFS[HR =0.55, 95%CI(0.44- 0.69),p<0.00001], and more slowly PD[ RR= 0.58, 95% CI(0.37-0.91), p= 0.02 ]than patients treated with conventional chemotherapy, the differences were statistically significant.Comparison with the overall adverse reactions were not significantly different [RR = 1.05, 95% CI(0.97-1.14), p = 0.20], but adverse reactions subgroup analysis of rituximab combined with conventional chemotherapy mantle cell lymphoma group more prone to allergies, the differences were statistically significant[RR = 6.91, 95% CI(1.85-25.79), P = 0.004].Conclusions: Rituximab combined with conventional chemotherapy improved ORR、CRR、OS 、PFS, and delayed PD; there was no increase other adverse reactions,except for more prone to allergies,clinical benefit was relatively higher than the risk of treatment caused; so it is confirmed that rituximab combined with conventional chemotherapy treatmenting mantle cell lymphoma have better efficacy.