Comparison of blinatumomab and CAR T-cell therapy in relapsed/refractory acute lymphoblastic leukemia: a systematic review and meta-analysis.

IF 2.3 4区医学 Q2 HEMATOLOGY

Expert Review of Hematology Pub Date : 2024-01-01 Epub Date: 2024-01-04 DOI:10.1080/17474086.2023.2298732

Yixin Zhai, Ju Hong, Jinhuan Wang, Yanan Jiang, Wenqi Wu, Yangyang Lv, Jing Guo, Linyan Tian, Huimeng Sun, Yuhang Li, Cheng Li, Hongjie Zhan, Zhigang Zhao

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引用次数: 0

Abstract

Objectives: This study evaluated the benefits and risks of patients with refractory or relapsed acute lymphocytic leukemia (R/R ALL) treated with anti-CD19 chimeric antigen receptor (CAR) T-cell therapy and blinatumomab.

Methods: PubMed, Web of Science, Embase, and the Cochrane Library were searched for relevant studies.

Results: The pooled complete remission (CR) rate and minimal residual disease (MRD) negative rate were 48%, 31% for blinatumomab, and 86% and 80% for CAR T-cell therapy.

Conclusions: The CAR T-cell therapy group exhibited a higher likelihood of CR rate than the blinatumomab group in every analysis regardless of adjustment subgroups. CAR T-cell therapy was associated with a significantly prolonged overall survival (OS) and relapse-free survival (RFS) compared with blinatumomab (2-year OS 55% vs 25%; 2-year RFS 40% vs 22%). CAR T-cell therapy was more effective for achieving CR and bridging to allogeneic hematopoietic stem cell transplantation (allo-SCT) than blinatumomab (2-year OS 75% vs. 57%). An emerging role for blinatumomab is as a bridging agent pre-SCT, and for patients who achieve an MRD-negative state pre-SCT, post-SCT outcomes are expected to be the same as CAR-T. For adverse effects (AEs), blinatumomab was associated with a lower rate of grade ≥3 hematological toxicity, CRS, and neurological events.

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复发性/难治性急性淋巴细胞白血病中blinatumomab与CAR T细胞疗法的比较：系统综述与荟萃分析。

研究目的本研究评估了接受抗CD19嵌合抗原受体（CAR）T细胞疗法和blinatumomab治疗的难治性或复发性急性淋巴细胞白血病（R/R ALL）患者的获益和风险：对PubMed、Web of Science、Embase和Cochrane图书馆的相关研究进行了检索：汇总的完全缓解（CR）率和最小残留病（MRD）阴性率分别为：blinatumomab为48%和31%，CAR T细胞疗法为86%和80%：无论调整分组如何，在所有分析中，CAR T细胞疗法组的CR率都高于blinatumomab组。与 blinatumomab 相比，CAR T 细胞疗法明显延长了总生存期（OS）和无复发生存期（RFS）（2 年 OS 55% vs 25%；2 年 RFS 40% vs 22%）。与blinatumomab相比，CAR T细胞疗法对达到CR和衔接异基因造血干细胞移植（allo-SCT）更有效（2年OS 75% vs. 57%）。blinatumomab的一个新角色是作为SCT前的桥接药物，对于在SCT前达到MRD阴性状态的患者，SCT后的结果预计与CAR-T相同。在不良反应（AEs）方面，blinatumomab与较低的≥3级血液毒性、CRS和神经事件相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.