Clinical Outcomes of CD۳۰-Targeted Chimeric Antigen Receptor T-cell (CAR-T) Therapy in Hodgkin Lymphoma: A Systematic Review

Hodgkin lymphoma (HL) is a type of cancer that originates in the lymphatic system, which is part of the body's immune system. It is characterized by the presence of Reed-Sternberg cells. Despite being one of the most treatable lymphomas, approximately ۱۰-۱۵% of patients do not respond to conventional treatments. Chimeric Antigen Receptor T-cell (CAR-T) therapy has emerged as a promising new approach for these patients. The aim of this study is to investigate the efficacy and safety of CAR-T cell therapy targeting CD۳۰ in HL patients through a systematic review of recent clinical trials. Methods: This systematic review was conducted using the keywords: Hodgkin Lymphoma, CAR-T Cell Therapy, CD۳۰, and related terms extracted from the MeSH database. Two researchers simultaneously performed searches in Google Scholar and PubMed databases up to August ۲۹, ۲۰۲۴. Inclusion criteria were alignment with the main objective of the study and articles written in English. Exclusion criteria included lack of access to the full text and incomplete information. Initially, ۵۱ articles were identified. After removing duplicates and irrelevant studies, ۱۹ clinical trials were selected for final analysis. Results: This review analyzed ۱۹ clinical trials on Hodgkin lymphoma using CAR-T cell therapy, involving ۲۹۶ participants with an average age of ۳۵.۳۵ years, of which ۶۸.۵۶% were male (n=۲۰۳) and ۳۱.۴۴% were female (n=۹۳). The most common adverse effects, reported in order of frequency from highest to lowest, were grade ۱ cytokine release syndrome (CRS) in ۶۳.۱۶% of studies, hematologic effects in ۴۲.۱۰%, skin rash and maculopapular rash in ۳۶.۸۴%, symptoms such as nausea, headache, dizziness, and fatigue in ۲۶.۳۱% of studies, grade ۲ CRS in ۱۵.۷۸%, pneumonia in ۱۵.۷۸%, and grade ۳ CRS in ۵.۲۶%. Neurotoxicity was reported in only one trial, affecting one patient (۰.۳۴%). The doses ranged from ۶ × ۱۰^۵ to ۲ × ۱۰^۸ CAR-T cells/m². Effective complementary treatments included pre-treatment chemotherapy, combination with PD-۱ inhibitors, and the use of brentuximab vedotin. Conclusion: CAR-T cell therapy shows promising potential in treating Hodgkin lymphoma, with manageable side effects and minimal observed neurotoxicity. There is a need for more precise standardization of CAR-T cell doses. Further research is important to explore complementary treatments that enhance the effectiveness of CAR-T cell therapy and improve patient outcomes.

کلیدواژه ها:

Hodgkin Lymphoma ، CAR-T Cell Therapy ، CD۳۰