来那度胺联合利妥昔单抗治疗滤泡性淋巴瘤的有效性与安全性的系统评价Meta分析

Efficacy and safety of Revlimid combined with Rituximab in the treatment of follicular lymphoma:A meta⁃analysis

目的:评价来那度胺联合利妥昔单抗治疗滤泡性淋巴瘤的临床有效性及安全性。方法:检索PubMed、Web of Science、Cochrane Library、Embase、中国医学生物服务系统(CBM)、维普数据库(VIP)、万方数据库(Wan Fang Data)、中国知网(CNKI)、及ClinicTrails.gov中有关来那度胺联合利妥昔单抗治疗滤泡性淋巴瘤的相关文献(建库至2022年6月23日)。按照纳入既定标准筛选出符合要求的文献后采用RevMan5.4及Stata14.0对数据进行Meta分析。结果:8项研究,865名滤泡性淋巴瘤患者被本文纳入。Meta分析结果表明,相比单用利妥昔单抗,来那度胺联合利妥昔单抗治疗滤泡性淋巴瘤的客观缓解率(RR=1.43,95%CI 1.26~1.61)及完全缓解率(RR=1.67,95%CI 1.27~2.21)均显著提高。然而,来那度胺联合利妥昔单抗组发生不良反应(中心粒细胞减少、腹泻、恶心呕吐、皮疹)的可能性较大,但均处于较低水平。结论:相较于单用利妥昔单抗治疗滤泡性淋巴瘤,来那度胺联合利妥昔单抗治疗可显著提高病人的客观缓解率和完全缓解率。然而该联合疗法可能出现皮疹等不良反应,治疗时应及时做出相应措施。因此,为进一步证实来那度胺联合利妥昔单抗治疗滤泡性淋巴瘤的有效性和安全性,有必要继续开展多中心、多样本、随机双盲对照实验及单臂实验进行验证。

Objective:To evaluate the clinical efficacy and safety of Revlimid combined with Rituximab in the treatment of follicular lymphoma.Methods:PubMed,Cochrane Library,Embase and Web of Science,China Medical Biological Service Sys⁃tem,China National Knowledge Infrastructure,VIP database,Wanfang database and ClinicTrials.gov were searched by comput⁃er Literature on Revlimid combined with Rituximab in the treatment of follicular lymphoma,from database establishment to June 23,2022.Eligible literatures were screened according to the inclusion criteria,and meta⁃analysis was performed using RevMan5.4 and Stata14.0. Results: A total of 8 studies including 865 patients were included. The results of the meta ⁃ analysis showed that compared with Rituximab alone, the objective response rate and complete response rate of Revlimid combined with Rituximab in the treatment of follicular lymphoma were significantly higher (objective response rate: RR=1.43, 95%CI 1.26⁃1.61;Complete response rate: RR=1.67, 95%CI 1.27⁃2.21). However, the Revlimid plus Rituximab group was more likely to have adverse ef⁃ fects (centripenia, diarrhea, nausea and vomiting, rash), but all at low levels. Conclusion: Compared with Rituximab alone, Rev⁃ limid combined with Rituximab significantly increased the objective and complete response rates in patients with follicular lympho⁃ ma. However, the combination therapy may cause rash and other adverse reactions, and corresponding measures should be taken in time. Therefore, it is necessary to continue to carry out multi⁃center, multi⁃sample, randomized double⁃blind controlled trials and single⁃arm experiments for validation.