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滤泡性淋巴瘤合并 POD24 患者的治疗与生存结局:系统综述与荟萃分析

英文原题:Treatment and survival outcomes for patients with follicular lymphoma and POD24: a systematic review and meta-analysis.

PubMed 2026/04/14(内容时间) Blood Adv Q1 · IF 7.7(JCR 2025)

研究概要

24 个月内疾病进展(POD24)的滤泡性淋巴瘤预后不良,是临床上的挑战。

中文摘要

进展性疾病在24个月内发生(POD24)的滤泡性淋巴瘤与预后不良相关,且带来临床挑战。因此,我们对POD24患者开展系统综述和汇总分析。共纳入21项试验、1242名参与者,评估总缓解率(ORR)、完全缓解(CR)、缓解持续时间和无进展生存期。在部分试验中,我们比较相同治疗方案下POD24与非POD24人群的汇总应答率。4项试验评估CAR-T细胞疗法治疗POD24患者。汇总分析显示,ORR为91.2%(95%置信区间[CI] 83.7–98.7),存在显著异质性(P=0.0414;I²=68.61%);CR率为75.7%(95% CI 55.1–96.4),异质性显著(P<0.0001;I²=93.99%)。对POD24患者使用不同双特异性抗体的特定应答率进行汇总分析,ORR为81.6%(95% CI 75.9–87.3),无异质性(P=0.6958;I²=0%);CR率为65.7%(95% CI 57.1–74.3),存在中度异质性(P=0.2148;I²=34.99%)。抗CD19抗体药物偶联物(ADC)/单克隆抗体(mAb)方面,loncastuximab联合rituximab以及tafasitamab联合R2(lenalidomide+rituximab)的ORR和CR率分别为100%和79.3%、87.5%和43.2%。研究还汇总分析了磷脂酰肌醇3-激酶抑制剂及含抗CD20 mAb的方案。结果显示抗CD19 CAR-T疗法取得最高CR率。此外,双特异性抗体、抗CD19 ADC/mAb,以及lenalidomide联合obinutuzumab或rituximab也显示出良好疗效。值得注意的是,lenalidomide联合obinutuzumab疗效优于R2方案。

展开英文摘要原文

Follicular lymphoma with progression of disease within 24 months (POD24) is associated with poor prognosis and represents clinical challenges. Therefore, we performed a systematic review and pooled analysis of patients with POD24. Twenty-one trials involving 1242 participants were included, assessing the overall response rate (ORR), complete response (CR), duration of response, and progression-free survival. In some trials, we compared pooled response rates between POD24 and non-POD24 populations with the same treatment regimen. Four trials evaluated chimeric antigen receptor (CAR) T-cell therapy in patients with POD24. Pooled analysis showed an ORR of 91.2% (95% confidence interval [CI], 83.7-98.7) with significant heterogeneity (P = .0414; I2 = 68.61%) and a CR of 75.7% (95% CI, 55.1-96.4) with significant heterogeneity (P< .0001; I2 = 93.99%). The specific response rates for different bispecific antibodies in POD24 were pooled analysis, the ORR was 81.6% (95% CI, 75.9-87.3) with no heterogeneity (P = .6958; I2 = 0%), and the CR was 65.7% (95% CI, 57.1-74.3) with moderate heterogeneity (P = .2148; I2 = 34.99%). For anti-CD19 antibody-drug conjugates (ADCs)/monoclonal antibodies (mAbs), the ORR and CR rate for loncastuximab plus rituximab and tafasitamab plus R2 (lenalidomide + rituximab) were 100% and 79.3%, and 87.5% and 43.2%, respectively. Phosphatidylinositol 3-kinase inhibitors and anti-CD20 mAb-containing regimens were also analyzed in pooled analyses. Our results demonstrated that anti-CD19 CAR T-cell therapy achieved the highest CR rate. Additionally, bispecific antibodies, anti-CD19 ADCs/mAbs, and the combination of lenalidomide with obinutuzumab or rituximab also exhibited excellent efficacy. Notably, lenalidomide plus obinutuzumab showed superior efficacy compared with R2.

论文信息

作者
Shen J、Zhang J、Zhu Z、Ma H、Zhang J、Zhou F、Tian H、Liu J
第一作者单位
Department of Hematology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China.China
通讯作者单位
Department of Hematology, Northern Theater General Hospital, Shenyang, China.China
文献类型
系统综述 · 荟萃分析
期刊
Blood advances2026 Apr 14
原文标识
PubMed 41587420 · DOI 10.1182/bloodadvances.2025018474