Meta-analysis of the comparative efficacy and safety of new drugs in combination with chemotherapy in primary plasmoblastic lymphoma.

Abstract

To systematically evaluate the efficacy and safety of regimens combining new drugs (bortezomib, etc.) with chemotherapy in the treatment of plasmaoblastoid lymphoma (PBL). PubMed, Embase, Web of Science, American Society of Hematology Annual Meeting Proceedings, Cochrane Controlled Trials Center Registry, Cochrane Library, Science Citation Index, and meeting abstracts were searched for quality evaluation based on Cochrane Risk and Jadad scores and other assessment tools. Patients were divided into subgroup 1 (traditional treatment vs. no treatment) and subgroup 2 (traditional treatment vs. combination of new drugs) based on medication use, and Revman 5.4 software was applied for statistical analysis. A total of 12 papers were included, including 410 patients with PBL. Meta-analysis results: the objective remission rate (ORR) of patients in the combination of new drugs group was higher than that of the traditional treatment group [56.8% (25/44) vs. 70.2% (66/94); OR = 2.18, 95%CI 1.58-2.78, P = 0.002 < 0.05], and the progression-free survival (PFS) rate of patients in the combination of new drugs group was higher than that of the traditional treatment group. the progression survival (PFS) was better than traditional treatment group (HR = 2.22, 95%CI 1.71-2.90, P < 0.001), and the heterogeneity between the results of each study I = 95%; there was no statistically significant difference between the two groups in terms of overall survival (OS) (HR = 1.81, 95%CI 0.44-7.46, P = 0.41), and grade 3-4 adverse events (AE) (HR = 0.85, 95%CI 0.27-7.46, P = 0.002 < 0.05). 95%CI 0.27-2.71, P = 0.78) were not statistically different. The regimen combining new drugs is an effective means to improve the prognosis of PBL, with better ORR and PFS than the traditional regimen, and there is no statistically significant difference between the two adverse events. However, the small sample size of this study increases the possibility of bias and the results need to be treated with caution.