Lymphoma, Non-Hodgkin

淋巴瘤, 非霍奇金
  • 文章类型: Journal Article
    Chimeric antigen receptor T (CAR-T) cell therapy is a rapidly developing new immunotherapy in recent years. Compared with other therapies, CAR-T has significant advantages for high-risk and relapsed/refractory B cell non-Hodgkin\'s lymphoma (B-NHL) patients. Currently, a variety of anti-CD19 CAR-T cells have been approved by the FDA for the treatment of B-NHL, such as axicabtagene ciloleucel, tisagenlecucel, lisocababtagene maraleucel and brexucabtagene autoleucel. In addition, many studies are actively exploring and developing different targeted CAR-T cells, which show great potential in B-NHL. This review briefly summarized the latest research progress on the application of CAR-T in common B-NHL.
    UNASSIGNED: CAR-T细胞免疫疗法在B细胞非霍奇金淋巴瘤中的应用进展.
    UNASSIGNED: 嵌合抗原受体T(CAR-T)细胞疗法是近年来迅速发展的免疫治疗新方法。相对于其他疗法,CAR-T疗法在高危及复发/难治性B细胞非霍奇金淋巴瘤(B-NHL)患者中具有显著优势。目前多种抗CD-19 CAR-T细胞已被FDA批准用于B-NHL的治疗,如阿基仑赛、司利弗明、利基迈仑赛、贝林妥欧单抗。除此之外,许多研究正在积极探索和开发不同靶点的CAR-T细胞,它们在B-NHL的治疗中表现出巨大的潜力。本文就CAR-T在常见B-NHL中的最新应用研究进展作一综述。 .
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  • 文章类型: Journal Article
    CAR-T细胞疗法,也称为嵌合抗原受体T细胞疗法,是免疫治疗非霍奇金淋巴瘤(NHL)领域的一种新方法。在接受CAR-T细胞治疗的患者中,氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描([18F]FDGPET/CT)在追踪治疗反应和评估免疫治疗的整体疗效方面发挥着关键作用。这项研究的目的是对旨在通过[18F]FDGPET/CT评估和预测接受CAR-T细胞治疗的NHL患者毒性的研究文献进行系统综述。两名研究人员询问了PubMed/MEDLINE和Cochrane中央对照试验注册(CENTRAL)数据库,以寻求涉及在接受CAR-T细胞治疗的淋巴瘤患者中使用[18F]FDGPET/CT的研究。全面的计算机文献检索允许纳入11项研究。通过使用第2版“诊断准确性研究质量评估”工具(QUADAS-2),系统评价中纳入的研究的偏倚风险评分为低。目前的文献强调[18F]FDGPET/CT在评估和预测接受CAR-T细胞治疗的NHL患者的毒性中的作用。强调CAR-T细胞疗法研究的演变性质。需要更多的研究来增加文献中收集的证据。
    CAR-T-cell therapy, also referred to as chimeric antigen receptor T-cell therapy, is a novel method in the field of immunotherapy for the treatment of non-Hodgkin\'s lymphoma (NHL). In patients receiving CAR-T-cell therapy, fluorodeoxyglucose Positron Emission Tomography/Computer Tomography ([18F]FDG PET/CT) plays a critical role in tracking treatment response and evaluating the immunotherapy\'s overall efficacy. The aim of this study is to provide a systematic review of the literature on the studies aiming to assess and predict toxicity by means of [18F]FDG PET/CT in patients with NHL receiving CAR-T-cell therapy. PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were interrogated by two investigators to seek studies involving the use of [18F]FDG PET/CT in patients with lymphoma undergoing CAR-T-cell therapy. The comprehensive computer literature search allowed 11 studies to be included. The risk of bias for the studies included in the systematic review was scored as low by using version 2 of the \"Quality Assessment of Diagnostic Accuracy Studies\" tool (QUADAS-2). The current literature emphasizes the role of [18F]FDG PET/CT in assessing and predicting toxicity in patients with NHL receiving CAR-T-cell therapy, highlighting the evolving nature of research in CAR-T-cell therapy. Additional studies are warranted to increase the collected evidence in the literature.
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  • 文章类型: Journal Article
    背景:原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的结外非霍奇金淋巴瘤,预后不良。18F-氟代脱氧葡萄糖正电子发射断层扫描(PET)/磁共振(MR)结合了PET和MR的优点。这项研究的目的是通过荟萃分析评估PET/MR诊断PCNSL的有效性。
    方法:万方数据库,SinoMed,中国国家知识基础设施,Cochrane图书馆,从数据库开始到2024年10月,将搜索PubMed和Embase有关PET/MRI在PCNSL诊断中的候选研究。将应用以下关键字:“原发性中枢神经系统淋巴瘤”,“原发性脑内淋巴瘤”,“正电子发射断层扫描磁共振”和“PET-MR”。符合纳入标准的研究将被纳入。没有完全真正积极的研究,假阳性,假阴性和真阴性值;以英语和中文以外的语言报告的研究;会议摘要全文不可用,病例报告将被排除。诊断准确性研究的质量评估将用于评估研究质量。将使用STATA软件(V.15.0)和Meta-Disc软件(V.1.4)进行荟萃分析。当异质性明显时,亚组分析将用于研究异质性的起源。分析的稳健性将通过敏感性分析进行检查。
    背景:这项研究基于公共数据库,不需要道德批准。在完成本系统评价和荟萃分析后,结果将寻求在同行评审的期刊上发表。
    CRD42023472570。
    BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin\'s lymphoma with poor prognosis. 18F-flourodeoxyglucose positron emission tomography (PET)/magnetic resonance (MR) combines the advantages of PET and MR. The aim of this study is to evaluate the validity of PET/MR for the diagnosis of PCNSL by means of a meta-analysis.
    METHODS: Wanfang Database, SinoMed, China National Knowledge Infrastructure, the Cochrane Library, PubMed and Embase will be searched for candidate studies about PET/MRI in PCNSL diagnosis from database inception to October 2024. The following keywords will be applied: \"Primary central nervous system lymphoma\", \"Primary intracerebral lymphoma\", \"Positron Emission Tomography Magnetic Resonance\" and \"PET-MR\". Studies meeting the inclusion criteria will be included. Studies without full true positive, false positive, false negative and true negative values; studies reported in languages other than English and Chinese; conference abstracts not available in full text and case reports will be excluded. Quality Assessment of Diagnostic Accuracy Studies will be used to evaluate the study quality. The STATA software (V.15.0) and Meta-Disc software (V.1.4) will be used to carry out meta-analysis. When heterogeneity is evident, subgroup analysis will be used to investigate the origin of heterogeneity. The robustness of the analysis will be checked with sensitivity analysis.
    BACKGROUND: This research is based on public databases and does not require ethical approval. The results will seek publication in a peer-reviewed journal after the completion of this systematic review and meta-analysis.
    UNASSIGNED: CRD42023472570.
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  • 文章类型: Systematic Review
    原发性干燥综合征(pSS),慢性自身免疫性疾病,与多种癌症的风险增加有关。本研究旨在利用深入的系统评价和荟萃分析方法探讨pSS与非霍奇金淋巴瘤(NHL)的潜在发展之间的关系。为了彻底探索这个话题,我们对文献进行了彻底的研究,从ProQuest等知名数据库中提取,PubMed,WebofScience,科克伦,谷歌学者。我们的数据收集时间一直持续到2024年2月8日,没有时间限制。用Stata14软件以p<0.05的显著性阈值分析数据。我们检查了15项队列研究,包括1997年至2023年的50,308名个体。研究结果揭示了pSS与NHL风险之间的实质性联系,在所有人口统计学中都很明显。具体来说,标准化发病率(SIR)一般为8.78(95%CI5.51,13.99),在两个男人身上观察到类似的趋势(SIR,6.29;95%CI1.93,20.51)和女性(SIR,9.60;95%CI5.89,15.63)。此外,SIR(10.50(95%CI7,15.75)),HR(2.82(95%CI1.28,6.18)),和OR(10.50(95%CI3.04,36.28))指数进一步支持这一关联。此外,与pSS相关的非NHL的风险在40-49岁的不同年龄组中很明显(SIR,30.13;95%CI14.62,62.08),50-59岁(先生,9.12;95%CI5.13,16.19),60-69岁(先生,9;95%CI4.68,17.32)。pSS实质上增加了NHL表现的可能性。它特别影响女性和成年早期阶段的女性,其敏锐度比男性和老年群体更高。
    Primary Sjögren\'s syndrome (pSS), a chronic autoimmune condition, has been associated with an increased risk of several cancers. This study aims to delve into the relationship between pSS and the potential development of non-Hodgkin\'s lymphoma (NHL) utilizing an in-depth systematic review and meta-analysis approach. To thoroughly explore the topic, we conducted a thorough examination of the literature, drawing from reputable databases such as ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar. Our data collection spanned until February 8, 2024, with no time limitation. Data were analyzed with Stata 14 software at a significance threshold of p < 0.05. We examined 15 cohort studies encompassing a total of 50,308 individuals from 1997 to 2023. The findings revealed a substantial link between pSS and the risk of NHL, evident across all demographics. Specifically, the standardized incidence ratio (SIR) was generally 8.78 (95% CI 5.51, 13.99), with similar trends observed in both men (SIR, 6.29; 95% CI 1.93, 20.51) and women (SIR, 9.60; 95% CI 5.89, 15.63). Additionally, the SIR (10.50 (95% CI 7, 15.75)), HR (2.82 (95% CI 1.28, 6.18)), and OR (10.50 (95% CI 3.04, 36.28)) indices further supported this association. Furthermore, the risk of non-NHL associated with pSS was noticeable across different age groups of 40-49 years (SIR, 30.13; 95% CI 14.62, 62.08), 50-59 years (SIR, 9.12; 95% CI 5.13, 16.19), and 60-69 years (SIR, 9; 95% CI 4.68, 17.32). pSS substantively augments the likelihood of NHL manifestation. It notably impacts females and those in earlier stages of adulthood with more acuity than males and older cohorts.
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  • 文章类型: Journal Article
    背景:针对CD19的嵌合抗原受体T(CART)细胞疗法的应用改善了成千上万的非霍奇金B细胞淋巴瘤(NHL)患者的预后。与各种CART细胞产品相关的毒性,然而,可能是严重的,很难预测。
    方法:在本系统综述和荟萃分析中,我们着手确定常见毒性是否存在可测量的差异,包括细胞因子释放综合征(CRS),免疫效应细胞相关神经毒性综合征(ICANS),血细胞减少,和感染,在市售用于治疗NHL的CART产品之间。
    结果:经过严格的研究选择过程,我们在15项前瞻性临床试验中纳入了1364名患者的队列,调查了axicabtageneciloleucel(axi-cel)的使用,lisocabtagenemaraleucel(liso-cel),和tisagenlecleucel(tisa-cel)。我们发现,与iso-cel和tisa-cel相比,axi-cel的CRS和ICANS的比率明显更高。相反,我们证明,使用肌细胞时,全级别和重度中性粒细胞减少的发生率显著增高.尽管严重感染率随axi-cel的增加而增加,但产品之间的嗜中性粒细胞减少症和所有等级的感染率没有显着差异。
    结论:总体而言,这项研究首次描述了与各种现有CART产品相关的毒性特征.通过更好地了解相关的毒性,可能有可能针对个体患者定制治疗方法,并在早期阶段预测毒性的发展。
    BACKGROUND: The application of CD19-directed chimeric antigen receptor T (CAR T) cell therapy has improved outcomes for thousands of patients with non-Hodgkin B cell lymphoma (NHL). The toxicities associated with various CAR T cell products, however, can be severe and difficult to anticipate.
    METHODS: In this systematic review and meta-analysis, we set out to determine whether there are measurable differences in common toxicities, including cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), cytopenias, and infections, between CAR T products that are commercially available for the treatment of NHL.
    RESULTS: After a stringent study selection process, we used a cohort of 1364 patients enrolled in 15 prospective clinical trials investigating the use of axicabtagene ciloleucel (axi-cel), lisocabtagene maraleucel (liso-cel), and tisagenlecleucel (tisa-cel). We found that the rates of CRS and ICANS were significantly higher with axi-cel as compared to both liso-cel and tisa-cel. Conversely, we demonstrated that rates of all-grade and severe neutropenia were significantly greater with liso-cel. Febrile neutropenia and all-grade infection rates did not differ significantly between products though rates of severe infection were increased with axi-cel.
    CONCLUSIONS: Overall, this study serves as the first to delineate toxicity profiles associated with various available CAR T products. By better understanding associated toxicities, it may become possible to tailor therapies towards individual patients and anticipate the development of toxicities at earlier stages.
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  • 文章类型: Journal Article
    目的:质子束疗法(PBT)为更局部地传递高能质子提供了机会,并可能减少对健康组织和重要器官的损害。这篇综述的目的是评估质子治疗对纵隔放疗诊断为霍奇金或非霍奇金淋巴瘤的患者的影响。
    方法:对EMBASE的系统搜索,根据PRISMA指南,通过OVID和CochraneLibrary于2022年5月进行了MEDLINE,以确定被诊断为霍奇金或非霍奇金淋巴瘤的患者的质子束治疗的疗效和毒性的相关数据。
    在566份筛选摘要中(去重复后430份),纳入了11项研究,共529名患者。所有研究均为2011-2021年间发表的病例系列。随访时间的中位数为15-63.6个月。在纳入的5项研究中,2年的总生存率(OS)从91%到98%不等。纳入的研究中有三项具有良好的结局,2年无进展生存期(PFS)为73%-94%。皮肤反应,发现食管炎和疲劳是最常见的1级和2级毒性。没有观察到急性或晚期4级和更高的毒性/不良事件。
    结论:有数据表明PBT可能是治疗纵隔霍奇金淋巴瘤和非霍奇金淋巴瘤的有效方法。因为所有的研究都是案例系列,本综述的作者对证据缺乏信心.仍然需要精心设计的随机对照试验,以告知HL和NHL中质子辐照的最佳方法。
    OBJECTIVE: Proton beam therapy (PBT) provides the opportunity for a more localized delivery of high energy protons and may reduce the damage to healthy tissues and vital organs. The aim of this review was to assess the effects of proton therapy for patients diagnosed with Hodgkin or non-Hodgkin lymphoma treated with mediastinal irradiation.
    METHODS: A systematic search of EMBASE, MEDLINE via OVID and Cochrane Library was conducted in May 2022 according to PRISMA guidelines to identify relevant data on the efficacy and toxicity of proton beam therapy for patients diagnosed with Hodgkin or non-Hodgkin lymphoma.
    UNASSIGNED: Of 566 screened abstracts (430 after de-duplication) 11 studies with a total of 529 patients were included. All studies were case series published between 2011-2021. Median range of follow-up time was 15-63.6 months. The overall survival (OS) for 2 years varied from 91% - 98% for 5 of the included studies. Three of the included studies had favourable outcomes with 2-year progression-free survival (PFS) ranging from 73% - 94%. Skin reaction, oesophagitis and fatigue were found to be the most common grade 1 and grade 2 toxicities. No acute or late grade 4 and higher toxicities/adverse events were observed.
    CONCLUSIONS: There are data indicating that PBT may to be an effective treatment against mediastinal Hodgkin and non-Hodgkin lymphoma. Because all the studies were case series, the authors of this review have little confidence in the evidence. There remains a need for well-designed randomized controlled trials to inform about the optimal approach to proton irradiation in HL and NHL.
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  • 文章类型: Meta-Analysis
    粒细胞集落刺激因子(G-CSF)和plerixafor的组合是多发性骨髓瘤(MM)患者造血干细胞动员的方法之一,非霍奇金淋巴瘤(NHL),和霍奇金淋巴瘤(HL)。本系统评价和荟萃分析旨在确定G-CSF+plerixafor动员外周血(PB)CD34+细胞的能力,并检查其安全性。
    我们使用术语“粒细胞集落刺激因子”进行了数据库搜索,\'G-CSF\',\'AMD3100\',和\'plerixafor\',直到2023年5月1日。该方法在PROSPERO数据库(CRD42023425760)中有更详细的描述。
    本系统综述和荟萃分析纳入了23项研究。与单独使用G-CSF相比,G-CSFplerixafor导致更多的患者获得了预定的CD34细胞单采率(OR,5.33;95%,4.34-6.55)。进一步发现G-CSF+plerixafor可以动员更多的CD34+细胞进入PB,这有利于下一次移植在两个随机对照(MD,18.30;95%,8.74-27.85)和单臂(MD,20.67;95%,14.34-27.00)试验。此外,与单独使用G-CSF相比,G-CSF+plerixafor并未引起更多的治疗紧急不良事件(OR,1.25;95%,0.87-1.80)。
    这项研究表明,G-CSF和plerixafor的组合,导致更多的MM患者,NHL,和HL,达到CD34+细胞的预定单采率,这与CD34+细胞更有效地动员到PB中有关。
    UNASSIGNED: The combination of granulocyte-colony stimulating factor (G-CSF) and plerixafor is one of the approaches for hematopoietic stem cell mobilization in patients with multiple myeloma (MM), non-Hodgkin\'s lymphoma (NHL), and Hodgkin\'s lymphoma (HL). This systematic review and meta-analysis aimed to determine the ability of G-CSF + plerixafor to mobilize peripheral blood (PB) CD34+ cells and examine its safety profile.
    UNASSIGNED: We performed a database search using the terms \'granulocyte colony stimulating factor\', \'G-CSF\', \'AMD3100\', and \'plerixafor\', published up to May 1, 2023. The methodology is described in further detail in the PROSPERO database (CRD42023425760).
    UNASSIGNED: Twenty-three studies were included in this systematic review and meta-analysis. G-CSF + plerixafor resulted in more patients achieving the predetermined apheresis yield of CD34+ cells than G-CSF alone (OR, 5.33; 95%, 4.34-6.55). It was further discovered that G-CSF + plerixafor could mobilize more CD34+ cells into PB, which was beneficial for the next transplantation in both randomized controlled (MD, 18.30; 95%, 8.74-27.85) and single-arm (MD, 20.67; 95%, 14.34-27.00) trials. Furthermore, G-CSF + plerixafor did not cause more treatment emergent adverse events than G-CSF alone (OR, 1.25; 95%, 0.87-1.80).
    UNASSIGNED: This study suggests that the combination of G-CSF and plerixafor, resulted in more patients with MM, NHL, and HL, achieving the predetermined apheresis yield of CD34+ cells, which is related to the more effective mobilization of CD34+ cells into PB.
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  • 文章类型: Review
    在现代免疫治疗时代,异基因造血干细胞移植(allo-HSCT)仍然是B细胞非霍奇金淋巴瘤(B-NHL)的潜在治愈选择。这项研究的目的是分析接受allo-HSCT的B-NHL患者的长期预后。我们分析了总生存期(OS),来自两个机构的53例接受allo-HSCT的患者的无进展生存期(PFS)和移植物抗宿主病(GVHD)无复发生存期(GRFS).该研究的中位随访时间为72个月(范围29-115个月)。在allo-HSCT之前,治疗线的中位数为3(范围1-6),有28名患者(53%)接受了先前的自体移植。三年PFS,OS和GRFS为55%,63%,55%,分别。一年非复发死亡率为26%。在多变量分析中,Karnofsky性能量表<90与操作系统较差相关。对接受嵌合抗原受体T细胞治疗的44例具有相似特征的患者进行非比较分析,显示1年PFS和OS分别为60%和66%,分别。我们的数据表明,allo-HSCT仍然是治疗某些R/RB-NHL患者的有用选择。我们的回顾性分析和文献综述表明,allo-HSCT可以在R/RB-NHL患者的一部分中提供持久的缓解。
    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still a potentially curative option for B-cell Non-Hodgkin Lymphoma (B-NHL) in the modern immunotherapy era. The objective of this study was to analyze long-term outcomes of patients with B-NHL who received allo-HSCT. We analyzed overall survival (OS), progression-free survival (PFS) and graft versus host disease (GVHD) relapse-free survival (GRFS) in 53 patients undergoing allo-HSCT from two institutions. The median follow-up of the study was 72 months (range 29-115 months). The median number of lines of therapy before allo-HSCT was 3 (range 1-6) and twenty-eight patients (53%) had received a previous autologous transplant. The 3-year PFS, OS and GRFS were 55%, 63%, and 55%, respectively. One-year non-relapse mortality was 26%. Karnofsky Performance Scale < 90 was associated with worse OS in multivariable analysis. A non-comparative analysis of a cohort of 44 patients with similar characteristics who received chimeric antigen receptor T-cell therapy was done, showing a 1-year PFS and OS were 60% and 66%, respectively. Our data shows that allo-HSCT is still a useful option for treating selected patients with R/R B-NHL. Our retrospective analysis and review of the literature demonstrate that allo-HSCT can provide durable remissions in a subset of patients with R/R B-NHL.
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  • 文章类型: Journal Article
    目的:化疗的脑室内途径,与更常用的鞘内给药相比,通过Ommaya水库(OMR)改善了药物在中枢神经系统(CNS)中的分布。我们回顾性回顾了我们在脑室内化疗的经验,专注于甲氨蝶呤,急性淋巴细胞白血病(ALL)和非霍奇金淋巴瘤(NHL)患者。
    方法:在1990年至2019年期间,确定了24名患者(年龄7天-22.2岁)进行26次OMR安置,共25,009个OMR天。对15例患者的59个疗程的OMR治疗中的甲氨蝶呤脑脊液(CSF)浓度(n=124)进行了分析。21个疗程仅在第0天进行甲氨蝶呤给药,而38个疗程在第1天、第2天或两者均有加强给药。我们模拟了给予各种给药方案的3天CSF甲氨蝶呤浓度保持>1µM的时间。
    结果:同时接受全身性甲氨蝶呤的患者的CSF甲氨蝶呤暴露高于单独接受OmR的患者(p<10-7)。我们的模拟显示,目前对3岁以上患者的心室内甲氨蝶呤强化策略在72小时40%的时间内维持CSF甲氨蝶呤浓度≥1µM。或者,预测其他加强策略在46%~72%的时间内达到CSF甲氨蝶呤浓度≥1µM持续72h.
    结论:OMR能够在7天至22岁的患者中安全地放置并在有或没有加强剂量的情况下在室内施用甲氨蝶呤。预计加强策略将增加脑脊液甲氨蝶呤浓度≥1µM持续72小时。
    OBJECTIVE: The intraventricular route of chemotherapy administration, via an Ommaya Reservoir (OmR) improves drug distribution in the central nervous system (CNS) compared to the more commonly used intrathecal administration. We retrospectively reviewed our experience with intraventricular chemotherapy, focused on methotrexate, in patients with Acute Lymphoblastic Leukemia (ALL) and Non-Hodgkin Lymphoma (NHL).
    METHODS: Twenty-four patients (aged 7 days - 22.2 years) with 26 OmR placements were identified for a total of 25,009 OmR days between 1990 and 2019. Methotrexate cerebrospinal fluid (CSF) concentrations (n = 124) were analyzed from 59 courses of OmR therapy in 15 patients. Twenty-one courses involved methotrexate dosing on day 0 only, whereas 38 courses involved booster dosing on days 1, 2, or both. We simulated the time CSF methotrexate concentrations remained > 1 µM for 3 days given various dosing regimens.
    RESULTS: CSF methotrexate exposure was higher in those who concurrently received systemic methotrexate than via OmR alone (p < 10- 7). Our simulations showed that current intraventricular methotrexate boosting strategy for patients ≥ 3 years of age maintained CSF methotrexate concentrations ≥ 1 µM for 72 h 40% of the time. Alternatively, other boosting strategies were predicted to achieve CSF methotrexate concentrations ≥ 1 µM for 72 h between 46 and 72% of the time.
    CONCLUSIONS: OmR were able to be safely placed and administer intraventricular methotrexate with and without boost doses in patients from 7 days to 22 years old. Boosting strategies are predicted to increase CSF methotrexate concentrations ≥ 1 µM for 72 h.
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  • 文章类型: Meta-Analysis
    嵌合抗原受体T细胞(CART细胞)疗法是复发性/难治性(R/R)大B细胞淋巴瘤(LBCL)的有效治疗方法。然而,在大多数CART细胞治疗试验中,中枢神经系统(CNS)淋巴瘤患者被排除.这项荟萃分析评估了CAR-T细胞疗法在中枢神经系统受累的LBCL患者中的疗效。两名评论者独立搜索PubMed和Cochrane图书馆,以确定与美国食品和药物管理局批准用于LBCL的CAR-T细胞疗法相关的所有已发表文献。纳入CNSLBCL患者。进行比例的Meta分析以评估总体反应(ORR),疗效完全反应(CR),和细胞因子释放综合征和免疫效应细胞相关神经毒性综合征的安全性评估。19项研究符合纳入141例CNSLBCL患者的条件。ORR和CR率分别为61%和55%。中位总生存期(OS)为8.8个月,中位无进展生存期(PFS)为4.4个月.在25%(32/130)的患者中报告了严重的免疫效应细胞相关神经毒性综合征(≥3级),在10%(13/124)的患者中发现了严重的细胞因子释放综合征(≥3级)。CART细胞疗法在CNSLBCL患者中的安全性和有效性似乎与没有CNS参与的患者相当。
    Chimeric Antigen Receptor T-cell (CAR T-cell) therapy is an effective treatment for relapsed/refractory (R/R) large B cell lymphoma (LBCL). However, patients with central nervous system (CNS) lymphoma were excluded in most of the CAR T-cell therapy trials. This meta-analysis assesses the efficacy with CAR T-cell therapy in LBCL patients with CNS involvement. Two reviewers independently searched PubMed and Cochrane Library to identify all published literature associated with United States Food and Drug Administration approved CAR T-cell therapies for LBCL. Patients with CNS LBCL were included. Meta-analysis of proportion was performed to evaluate the overall response (ORR), complete response (CR) for efficacy, and cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome for safety assessment. Nineteen studies were qualified for inclusion with 141 CNS LBCL patients. The ORR and CR rates were 61% and 55% respectively. The median overall survival (OS) was 8.8 months, and the median progression free survival (PFS) was 4.4 months. Severe immune effector cell-associated neurotoxicity syndrome (grade≥3) were reported in 25% (32/130) patients and severe cytokine release syndrome (grade≥3) were found in 10% (13/124) of the patients. The safety and efficacy of CAR T-cell therapy in CNS LBCL patients appears comparable to patients without CNS involvement.
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