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Review Article

使用CD19靶向嵌合抗原受体T细胞过继免疫治疗B细胞恶性肿瘤：系统评价疗效和安全性

卷 26, 期 17, 2019

页: [3068 - 3079] 页: 12

弟呕挨: 10.2174/0929867324666170801101842

价格: $65

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摘要

背景：过继输注嵌合抗原受体转导的T细胞（CAR-T）是血液恶性肿瘤免疫治疗的有力工具，最近发表的和未发表的临床结果证明了这一点。 目的：在本报告中，我们进行了一项Meta分析，以评估CAR-T对难治性和/或复发性B细胞恶性肿瘤（包括白血病和淋巴瘤）的疗效和副作用。 方法：通过检索PubMed和EMBASE，确定CAR-T在急性和慢性淋巴细胞白血病和淋巴瘤中的有效性和安全性的临床研究。 分析的疗效结果是完全缓解（CR）和部分缓解（PR）的比率。 安全性参数是不良反应的患病率，包括发热，低血压和急性肾衰竭。 使用R软件进行Meta分析。 计算每个结果的加权风险比（HR）和95％置信区间。 根据纳入研究的异质性，采用固定或随机效应模型。 结果：纳入了19项已发表的临床研究，共有391名患者进行Meta分析。 汇总完全缓解率为55％（95％CI 41％-69％）; 汇总的部分缓解率为25％（95％CI：19％-33％）。 发热的患病率为62％（95％CI：41％-79％），低血压为22％（95％CI：15％-31％），急性肾功能衰竭为24％（95％CI：16） ％-34％）。 所有不良反应均可控制，并且由于毒性未报告死亡。 结论：CD19靶向CAR-T是治疗难治性B细胞恶性肿瘤（包括白血病和淋巴瘤）的有效方式。 然而，仍然需要制定改善其临床应用安全性的策略。

关键词: 嵌合抗原受体，过继性T细胞疗法，B细胞恶性肿瘤，白血病，淋巴瘤，安全性。

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