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Annals of Hematology
Published in: Annals of Hematology 4/2021

01-04-2021 | Acute Lymphoblastic Leukemia | Original Article

Anti-CD19 CAR-T cell therapy bridge to HSCT decreases the relapse rate and improves the long-term survival of R/R B-ALL patients: a systematic review and meta-analysis

Authors: Linhui Hu, Alice Charwudzi, Qian Li, Weiwei Zhu, Qianshan Tao, Shudao Xiong, Zhimin Zhai

Published in: Annals of Hematology | Issue 4/2021

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Abstract

Chimeric antigen receptor (CAR) T cell therapy improves the remission rate of refractory/relapsed B-acute lymphoblastic leukemia (R/R B-ALL) patients, but the relapse rate remains high. Recent studies suggest patients who underwent post-chimeric antigen receptor T cell therapy hematopoietic stem cell transplantation (post- HSCT) would achieve durable remission and better survival, but this remains controversial. To this end, we conducted a meta-analysis to assess the role of post-HSCT in R/R B-ALL. The Cochrane Library, Embase, and PubMed were used to identify relevant studies; the latest search update was on July 05, 2020. We used the Cochran Q test and I-squared statistics to test for heterogeneity among the studies analyzed. The fixed model and random model were used to combine results when appropriate. We performed all statistical analyses with Stata 12, and P < 0.05 was considered statistically significant. We included 18 studies with 758 patients in the meta-analysis. Our results indicated that post-HSCT was associated with lower relapse rate (RR: 0.40, 95% CI: 0.32–0.50, P = 0.000), better overall survival (HR: 0.37, 95% CI: 0.19–0.71, P = 0.003), better leukemia-free survival (HR: 0.20, 95% CI: 0.10–0.40, P = 0.000). However, post-HSCT did not influence OS in Caucasians, and CAR-T cells with CD28 co-stimulation factor bridged to HSCT did not influence OS. Post-HSCT decreased the relapse rate and improved the long-term survival of R/R B-ALL patients. R/R B-ALL patients would benefit from post-HSCT after CAR-T cell therapy.
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Metadata
Title
Anti-CD19 CAR-T cell therapy bridge to HSCT decreases the relapse rate and improves the long-term survival of R/R B-ALL patients: a systematic review and meta-analysis
Authors
Linhui Hu
Alice Charwudzi
Qian Li
Weiwei Zhu
Qianshan Tao
Shudao Xiong
Zhimin Zhai
Publication date
01-04-2021
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 4/2021
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-021-04451-w

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