The efficacy of anti-CD19 chimeric antigen receptor T cells for B-cell malignancies

Cytotherapy. 2019 Jul;21(7):769-781. doi: 10.1016/j.jcyt.2019.04.005. Epub 2019 May 31.

Abstract

Immunotherapy with chimeric antigen receptor T (CAR-T) cells has proved remarkably effective in recently published clinical trials. In this meta-analysis, we performed a systematic review in terms of the clinical response treated with CAR-T cells in acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL) and lymphomas patients. Thirty-eight published clinical studies including 665 patients were eligible for response rate (RR) evaluation. The overall pooled RR of CD19-CAR-T cells was 72% (95% confidence interval: 62-77%). The various clinical parameters were analyzed. RR was 81% in ALL, 68% in lymphoma and 70% in CLL. RR in patients who received interleukin (IL)-2 was 70%, whereas in those who did not receive IL-2, it was 74%. RR was 75% with lymphodepletion and 56% without lymphodepletion. RR with autologous cells was 76% and 57% with allogeneic cells. In conclusion, this meta-analysis showed a high clinical RR of CD19-CAR-T cell-based immunotherapy in patients with refractory B-cell malignancies.

Keywords: CAR-T; acute lymphocytic leukemia; chronic lymphocytic leukemia; lymphomas; meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antigens, CD19 / immunology*
  • B-Lymphocytes / immunology
  • B-Lymphocytes / pathology
  • Clinical Trials as Topic
  • Female
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / methods*
  • Leukemia, B-Cell / immunology*
  • Leukemia, B-Cell / therapy
  • Leukemia, T-Cell / immunology*
  • Leukemia, T-Cell / therapy
  • Lymphoma / immunology
  • Lymphoma / therapy
  • Lymphoma, B-Cell / immunology
  • Lymphoma, B-Cell / therapy
  • Lymphoma, T-Cell / immunology
  • Lymphoma, T-Cell / therapy
  • Male
  • Receptors, Chimeric Antigen / genetics
  • Receptors, Chimeric Antigen / immunology*
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / transplantation

Substances

  • Antigens, CD19
  • Receptors, Chimeric Antigen