Prevalence of GVHD in Patients With B-Cell Malignancies Receiving Allogeneic CAR T-Cells

In a meta-analysis presented at the 2022 American Society of Clinical Oncology Annual Meeting, researchers evaluated allogeneic chimeric antigen receptor (CAR) T-cell therapy in patients with B-cell malignancies, citing the concern of graft-versus-host disease (GHVD) development. Based on their data, however, they found that CAR T-cell immunotherapy exhibited an acceptable safety and efficacy profile in this population.

The meta-analysis assessed PubMed, Embase, Cochrane, and ClinicalTrials.gov databases through January 26, 2022, and identified 9 clinical trials with a pooled cohort of 146 patients. Articles were initially identified using medical subject headings and search keywords related to B-cell malignancies and CAR T-cell therapy. References in previously published systematic reviews were also evaluated for relevant studies.

The primary outcomes of interest were complete remission (CR), 1-year overall survival (OS), incidence of GVHD, cytokine release syndrome (CRS), and immune effector cell-associated neurotoxicity (ICANS).

The cohort had a median age ranging from 19 to 49 years, and the most common B-cell malignancy was acute lymphoblastic leukemia (n = 126; 86%). All patients received CD-19-targeted therapy with cell doses ranging from 0.4×10⁶ cells/kg to 5×10⁸ cells/kg.

Notably, 93 of 146 patients achieved CR for a pooled rate of 63% (95% CI, 47.4-78.6), and the pooled proportion of patients who developed GVHD was 9.4% (95% CI, 3.1-15.6). Additionally, the pooled 1-year OS rate was 57.3% (95% CI, 30.8-82.0), the pooled CRS rate was 59.3% (95% CI, 30.5-88.1), and the pooled ICANS rate was 15.4% (95% CI, 4.6-26.3).

The study’s authors advanced that allogeneic CAR T-cell therapies are promising in patients with B-cell malignancies but noted that several trials are ongoing and longer follow-up is needed to fully evaluate the therapy.

Reference

Chattaraj A, Ebad Ur Rehman M, Khan I, et al. Safety and efficacy of allogeneic CAR-T cells in B-cell malignancies: a systematic review and meta-analysis. Abstract #19530. Presented at the 2022 American Society of Clinical Oncology Annual Meeting; June 3-7, 2022; Chicago, IL.