Ibrahiam Amir T, Geddada Sunitha, Ullah Najeeb, Al-Qassab Zahraa M, Ahmed Osman, Khan Safeera
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
General Surgery, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2024 Dec 17;16(12):e75854. doi: 10.7759/cureus.75854. eCollection 2024 Dec.
Chimeric antigen receptor (CAR) T-cell therapy has shown very promising results in the treatment of refractory or relapsed diffuse large B-cell lymphoma (DLBCL). This systematic review evaluates the effectiveness and side effects of CAR T-cell therapies, focusing on factors affecting both clinical outcomes and adverse effects. This review included data from 14 studies involving 1392 patients with DLBCL who underwent CAR T-cell therapy. These studies include both randomized clinical trials and observational studies, which would help to analyze the effectiveness and safety profiles. The review highlights that CAR T-cell therapies, mainly tisagenlecleucel (Tisa-cel) and axicabtagene ciloleucel (Axi-cel), have shown superior effectiveness in comparison to standard chemotherapy in patients with relapsed or refractory DLBCL. Lisocabtagene maraleucel (Liso-cel) showed significant improvement outcomes in event-free and progression-free survival. However, CAR T-cell therapies are associated with many side effects. The most common side effects include hematologic toxicity, prolonged neutropenia, and infections, while clinical outcomes are highly impacted by many factors, which include a pro-inflammatory state, PPM1D gene mutation, infusion timing, and circulating monocytes.
嵌合抗原受体（CAR）T细胞疗法在难治性或复发性弥漫性大B细胞淋巴瘤（DLBCL）的治疗中显示出非常有前景的结果。本系统评价评估了CAR T细胞疗法的有效性和副作用，重点关注影响临床结局和不良反应的因素。本评价纳入了14项研究的数据，涉及1392例接受CAR T细胞疗法的DLBCL患者。这些研究包括随机临床试验和观察性研究，这将有助于分析有效性和安全性概况。该评价强调，CAR T细胞疗法，主要是替雷利珠单抗（Tisa-cel）和阿基仑赛（Axi-cel），在复发或难治性DLBCL患者中与标准化疗相比显示出更高的有效性。利妥昔单抗（Liso-cel）在无事件生存期和无进展生存期方面显示出显著改善的结果。然而，CAR T细胞疗法与许多副作用相关。最常见的副作用包括血液学毒性、长期中性粒细胞减少和感染，而临床结局受到许多因素的高度影响，这些因素包括促炎状态、PPM1D基因突变、输注时间和循环单核细胞。
