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

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.