School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia.
BMC Cancer. 2022 Nov 25;22(1):1218. doi: 10.1186/s12885-022-10223-0.
Combination chemoimmunotherapy (CIT) consisting of anti-CD20 has improved the progression-free survival (PFS) and overall survival (OS) of patients with chronic lymphocytic leukaemia (CLL). We performed a comprehensive synthesis of prognostic factors in patients with CLL on combined CIT with anti-CD20 antibodies compared with standard chemotherapy alone or targeted therapy.We searched the MEDLINE and academic search complete electronic databases as well as clinicaltrials.gov (from inception up to 01 August 2022) for randomised controlled trials examining chemoimmunotherapy and targeted therapy in patients with CLL. The risk of bias and the quality of evidence was assessed using the quality in prognostic studies tool (QUIPS).A total of 10 prognostic factors were identified and evaluated in patients with CLL on anti-CD20 antibody-containing CIT. The predictive value of the following prognostic factors was confirmed and associated with poor patient outcomes; deletion 17p (HR = 3.39), Immunoglobulin heavy chain variable region gene mutation status (HR = 0.96) and βmicroglobulin (HR = 1.41).Conventional predictive factors may have retained prognostic value and could be useful in the stratification of patients who may be non-responsive to CIT.Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) registry (CRD42021218997).
联合化疗免疫治疗（CIT）包含抗 CD20 抗体，改善了慢性淋巴细胞白血病（CLL）患者的无进展生存期（PFS）和总生存期（OS）。我们对接受抗 CD20 抗体联合 CIT 的 CLL 患者的预后因素进行了全面综合分析，与单独标准化疗或靶向治疗相比。我们在 MEDLINE 和学术搜索完整电子数据库以及 clinicaltrials.gov（从建立到 2022 年 8 月 1 日）中搜索了检查 CLL 患者化疗免疫治疗和靶向治疗的随机对照试验。使用预后研究质量工具（QUIPS）评估偏倚风险和证据质量。共确定了 10 个预后因素，并在接受含抗 CD20 抗体 CIT 的 CLL 患者中进行了评估。以下预后因素的预测价值得到了证实，并与患者预后不良相关：缺失 17p（HR=3.39）、免疫球蛋白重链可变区基因突变状态（HR=0.96）和β-微球蛋白（HR=1.41）。传统的预测因素可能仍然具有预后价值，并可用于分层可能对 CIT 无反应的患者。试验注册：国际前瞻性系统评价注册库（PROSPERO）（CRD42021218997）。
