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TP53 突变弥漫大 B 细胞淋巴瘤的治疗结局:系统综述与荟萃分析

英文原题:Therapeutic outcomes of TP53-mutated diffuse large B cell lymphoma: A systematic review and meta-analysis.

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Therapeutic outcomes of TP53-mutated diffuse large B cell lymphoma: A systematic review and meta-analysis.

PubMed 2026/08/06(内容时间) iScience Q1 · IF 4.5(JCR 2025)

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中文摘要

TP53突变与弥漫性大B细胞淋巴瘤(DLBCL)的早期进展和不良预后相关。本系统综述和meta分析评估了TP53突变(TP53m)DLBCL不同治疗的缓解结局。共识别出33,762条记录,纳入31项研究,包含1,164例TP53m DLBCL患者。在新诊断(ND)背景下,接受靶向治疗(TT)联合化疗的患者中,汇总完全缓解(CR)率为60%(95% CI:50%-69%;n = 552;I 2 = 75.7%),汇总总缓解率(ORR)为80%(95% CI:74%-86%;n = 202;I 2 = 0%)。在复发/难治(R/R)背景下,接受CAR-T 细胞治疗的患者中,汇总CR率为39%(95% CI:24%-54%;n = 139;I 2 = 64.2%),汇总ORR为77%(95% CI:43%-99%;n = 131;I 2 = 94.1%)。TT联合化疗和基于CAR-T 的治疗在TP53突变DLBCL中显示出令人鼓舞的活性,但需要更大规模的前瞻性研究来确定其临床作用。

展开英文摘要原文

TP53 mutations are associated with early progression and poor prognosis in diffuse large B cell lymphoma (DLBCL). This systematic review and meta-analysis evaluated remission outcomes of different therapies in TP53 -mutated (TP53m) DLBCL. In total, 33,762 records were identified, and 31 studies comprising 1,164 patients with TP53m DLBCL were included. In the newly diagnosed (ND) setting, among patients treated with targeted therapy (TT) plus chemotherapy, the pooled complete remission (CR) rate was 60% (95% CI: 50%-69%; n = 552; I 2 = 75.

7%) and the pooled overall remission rate (ORR) was 80% (95% CI: 74%-86%; n = 202; I 2 = 0%). In the relapsed/refractory (R/R) setting, among patients treated with chimeric antigen receptor T cell (CAR-T) therapy, the pooled CR rate was 39% (95% CI: 24%-54%; n = 139; I 2 = 64. 2%) and the pooled ORR was 77% (95% CI: 43%-99%; n = 131; I 2 = 94. 1%). TT plus chemotherapy and CAR-T-based therapy show encouraging activity in TP53-mutated DLBCL, but larger prospective studies are required to define their clinical roles.

论文信息

作者
Zhou X、Jiang Y、Li A、Kong D、Zhang P、Shan N
单位
Department of Hematology, The Second Qilu Hospital of Shandong University, 247 Beiyuan Road, Jinan, Shandong 250033, China.China
期刊
iScience2026 Aug 21
原文标识
PubMed 42602990 · DOI 10.1016/j.isci.2026.117049