Therapeutics and Clinical Risk Management (May 2019)
Survival outcomes and efficacy of autologous CD19 chimeric antigen receptor-T cell therapy in the patient with diagnosed hematological malignancies: a systematic review and meta-analysis
Abstract
Emmanuel Kwateng Drokow,1 Hafiz Abdul Waqas Ahmed,1 Cecilia Amponsem-Boateng,2 Gloria Selorm Akpabla,3 Juanjuan Song,1 Mingyue Shi,1 Kai Sun11Department of Hematology, Zhengzhou University People‘s Hospital & Henan Provincial People‘s Hospital Henan, Zhengzhou, People’s Republic of China; 2Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People’s Republic of China; 3Department of Internal Medicine, Tianjin Medical University, Tianjin, People’s Republic of ChinaPurpose: Chimeric Antigen Receptor T(CAR-T) cell therapy is an immunotherapy approach used in treating cancer which has seen rapid development over the decades. It becomes the preferred treatment choice after patients have failed conventional chemotherapy.Methods: We conducted a meta-analysis in 320 patients from 14 studies to estimate the survival outcome, response rate and toxicity of autologous CD19 CAR-T cell therapy and predict other factors associated with a better prognosis.Results: The overall response rate was 71.88% (95% CI: 61.34–80.46%, p<0.01) and CRS toxicity was 60.15% (95% CI: 42.87–75.22%, p<0.01). Patients who received lymphodepletion was associated with a better response rate (77%, 95%CI: 67–83%; p-value =0.001) in comparison to the other patients who did not (66%, 95%CI: 41–83%).Conclusion: Lymphodepletion regimen may play a crucial role in predicting the prognosis of patients with hematological malignancies. Lymphodepletion patients had better progression-free survival than those who did not.Keywords: autologous, CD19, CAR-T, hematological malignancies, response rate
