Table 2.
Selective trials for combinations of CAR T cell therapy with HSCT.
| Trial | Disease | N | Target | Outcome | Toxicity |
|---|---|---|---|---|---|
| CAR T cell therapy following consolidative allo-HSCT | |||||
| Gu et al. (2021) (52) | B-ALL | 30 | CD19 | OS (2y): allo-HSCT (30): 59%; non-HSCT (26): 23% (HR=0.29; 95%CI: 0.13–0.65; P=0.001) LFS (2y): allo-HSCT: 53%; non-HSCT: 19% (HR=0.20; 95%CI: 0.09–0.45; P<0.001) |
CRS: 43%; ICANS: 9% aGVHD: 30%; cGVHD: 50% |
| Li et al. (2021) (53) | B-ALL | 137 | CD19/CD22 | OS (2y): 74%; LFS (2y): 64% | grade II-IV aGVHD: 42%; cGVHD: 18% |
| Hu et al. (2021) (54) | B-ALL | 52 | CD19 | OS (2y): 84%; EFS (2y): 76% | CRS: 58%; ICANS: 15% aGVHD: 28%; cGVHD: 35% |
| Zhao et al. (2020) (55) | B-ALL | 55 | CD19 | OS (2y): allo-HSCT (55): 77%; non-HSCT (67): 36% (HR=0.275; 95%CI: 0.142-0.531; P<0.001) LFS (2y): allo-HSCT: 66%; non-HSCT: 33% (HR=0.244; 95%CI: 0.136~0.437; P<0.0001) |
CRS: 93%; ICANS: 75% aGVHD: 64%; cGVHD: 40% |
| Zhang et al. (2020) (56) | B-ALL | 75 | CD19 | OS (1y): allo-HSCT (75): 79%; non-HSCT (40): 32% (HR=0.048; 95% CI: 0.016-0.148; P<0.0001) LFS (1y): allo-HSCT: 77%; non-HSCT: 12% (HR=35.45; 95%CI: 11.6-108.4; P<0.0001) |
CRS: 92%; ICANS: 21% |
| Park et al. (2018) (57) | B-ALL | 17 | CD19 | OS (2y): allo-HSCT (17): 33%; non-HSCT (36): 45% (P=0.89) EFS (2y): allo-HSCT: 24%; non-HSCT: 27% (P=0.64) |
CRS: 85%; ICANS: 43% 6 TRM |
| Shadman et al. (2019) (58) | B-NHL/CLL | 13 | CD19 | OS (1y): 59% (95% CI: 0.37-0.95) | aGVHD: 85%; cGVHD: 8% |
| Allo-HSCT following allo-CAR T cell therapy | |||||
| Zhao et al. (2022) (59) | B-ALL | 12 | CD19 | OS (424.5d): 100%; DFS (424.5d): 65.6% | CRS: 66.7% aGVHD: 0% |
| Kebriaei et al. (2016) (60) | B-ALL/DLBCL | 19 | CD19 | ORR: 57.9%; CR: 52.6% OS (1y): 63%; PFS (1y): 53% |
aGVHD: 15.8% |
| Allo-CAR T cell concurrent with allo-HSCT | |||||
| Yang et al. (2021) (61) | B-NHL/ MM |
11 | CD19/CD20/CD22/BCMA | ORR: 55%; CR: 46% | CRS: 100% aGVHD: 3pts |
| CAR T cell therapy following ASCT | |||||
| Wei et al. (2022) (62) | B-NHL | 57 | CD19+CD22 | ORR: 95%; CR: 85% | CRS: 95%; ICANS: 19% |
| Wang et al. (2022) (63) | B-NHL | 21 | CD19 | ORR: 90%; CR: 71%; OS (3y): 80%; PFS (3y): 80% | CRS: 76%; ICANS: 0% |
| Cao et al. (2021) (64) | B-NHL | 42 | CD19+CD22 | ORR: 91%; CR: 81% PFS: 83% (2y) | CRS: 96%; ICANS: 21% |
| Hu et al. (2021) (65) | B-NHL | 12 | CD22+CD20 | ORR: 58%; CR: 58%; OS (9m): 71%; PFS (9m): 67% | CRS: 92%; ICANS: 8% |
| Wu et al. (2021) (66) | B-NHL | 13 | CD19+CD22 | ORR: 82%; CR: 55%; OS (1y): 83%; PFS (1y): 75% | CRS: 85%; ICANS: 27% |
| Wang et al. (2020) (67) | B-NHL | 14 | CD19 | ORR: 79%; CR: 43%; OS (1y): 65%; PFS (6m): 64% | CRS: 86%; ICANS: 0% |
| Sauter et al. (2019) (68) | B-NHL | 15 | CD19 | ORR: 53%; CR: 53%; PFS (2y): 30% | CRS: 40%; ICANS: 67% |
| Wang et al. (2016) (69) | B-NHL | 16 | CD19 | ORR: 81%; CR: 56%; PFS (1y): 63% | ≥grade II CRS: 0%; ICANS: 0% |
| Garfall et al. (2018) (70) | MM | 10 | CD19 | ORR: 80% (PR: 2; VGPR: 6) | CRS:10% autologous GVHD: 10% |
| Shi et al. (2018) (71) | MM | 9 | CD19+BCMA | ORR: 100%; CR: 33.3% | CRS: 100% |
CAR, chimeric antigen receptor; HSCT, hemopoietic stem cell transplantation; N: number of patients; B-ALL, B-cell acute lymphoblastic leukemia; Allo-HSCT, allogeneic HSCT; OS, overall survival; EFS, event-free survival; LFS, leukemia-free survival; HR, hazard ratio; CRS, cytokine release syndrome; ICANS, immune effector cell-associated neurotoxicity syndrome; aGVHD, acute graft versus host disease; cGVHD, chronic GVHD; B-NHL, B-cell non-Hodgkin lymphoma; CLL, chronic lymphocytic leukemia; DFS, disease-free survival; pts, patients; DLBCL, diffuse large B cell lymphoma; PFS, progression-free survival; d, day; MM, multiple myeloma; ORR, overall response rate; CR, complete response; PR, partial response; VGPR, very good partial response; TRM, transplant-related mortality.