Non-relapse mortality after CAR T-cell therapy: A systematic review and meta-analysis of 7,788 lymphoma and myeloma patients
Abstract While CAR-T therapy represents a transformative immunotherapy, it is also associated with distinct toxicities that contribute to morbidity and mortality. In this systematic review and meta-analysis, we searched MEDLINE, Embase and CINAHL for reports of non-relapse mortality (NRM) following CAR-T in lymphoma and myeloma, published until 09/2023. Cumulative incidence rates of NRM and causes/numbers of death were extracted. NRM point estimates were analyzed using fixed effect models. We identified 7,788 patients across 16 clinical trials and 32 real-world studies. After a median follow-up of 12.9 months, the overall NRM rate was 7.5% (95%CI 6.9-8.1%). NRM point estimates were related to the disease entity, CAR-T product and costimulatory domain. Of 582 reported non-relapse deaths, nearly half were attributed to infections, followed by cardiovascular/respiratory events (7.4%) and second malignancies (6.5%). Our findings underline the critical importance of post-CAR-T infections and support the comprehensive reporting of NRM, including specific causes and long-term outcomes..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 01. Feb. Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rejeski, Kai [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-3907430/v1 |
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| 520 | |a Abstract While CAR-T therapy represents a transformative immunotherapy, it is also associated with distinct toxicities that contribute to morbidity and mortality. In this systematic review and meta-analysis, we searched MEDLINE, Embase and CINAHL for reports of non-relapse mortality (NRM) following CAR-T in lymphoma and myeloma, published until 09/2023. Cumulative incidence rates of NRM and causes/numbers of death were extracted. NRM point estimates were analyzed using fixed effect models. We identified 7,788 patients across 16 clinical trials and 32 real-world studies. After a median follow-up of 12.9 months, the overall NRM rate was 7.5% (95%CI 6.9-8.1%). NRM point estimates were related to the disease entity, CAR-T product and costimulatory domain. Of 582 reported non-relapse deaths, nearly half were attributed to infections, followed by cardiovascular/respiratory events (7.4%) and second malignancies (6.5%). Our findings underline the critical importance of post-CAR-T infections and support the comprehensive reporting of NRM, including specific causes and long-term outcomes. | ||
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