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  • Outcomes with chimeric anti...
    Shahzad, Moazzam; Nguyen, Andrea; Hussain, Ali; Ammad-Ud-Din, Mohammad; Faisal, Muhammad Salman; Tariq, Ezza; Ali, Fatima; Butt, Atif; Anwar, Iqra; Chaudhary, Sibgha Gull; Lutfi, Forat; Ahmed, Nausheen; Singh, Anurag K; Hematti, Peiman; McGuirk, Joseph P; Mushtaq, Muhammad Umair

    Frontiers in immunology, 04/2023, Letnik: 14
    Journal Article

    We conducted a systematic review and meta-analysis to evaluate outcomes following chimeric antigen receptor T cell (CAR-T) therapy in relapsed/refractory acute myeloid leukemia (RR-AML). We performed a literature search on PubMed, Cochrane Library, and Clinicaltrials.gov. After screening 677 manuscripts, 13 studies were included. Data was extracted following PRISMA guidelines. Pooled analysis was done using the meta-package by Schwarzer et al. Proportions with 95% confidence intervals (CI) were computed. We analyzed 57 patients from 10 clinical trials and 3 case reports. The pooled complete and overall response rates were 49.5% (95% CI 0.18-0.81, I =65%) and 65.2% (95% CI 0.36-0.91, I =57%). The pooled incidence of cytokine release syndrome, immune-effector cell associated neurotoxicity syndrome, and graft-versus-host disease was estimated as 54.4% (95% CI 0.17-0.90, I =77%), 3.9% (95% CI 0.00-0.19, I =22%), and 1.6% (95%CI 0.00-0.21, I =33%), respectively. CAR-T therapy has demonstrated modest efficacy in RR-AML. Major challenges include heterogeneous disease biology, lack of a unique targetable antigen, and immune exhaustion.