Background: Adoptive infusion of chimeric antigen receptor transduced T- cells
(CAR-T) is a powerful tool of immunotherapy for hematological malignancies, as evidenced
by recently published and unpublished clinical results.
Objective: In this report, we performed a meta-analysis to evaluate the efficacy and side effects
of CAR-T on refractory and/or relapsed B-cell malignancies, including leukemia and
Methods: Clinical studies investigating efficacy and safety of CAR-T in acute and chronic
lymphocytic leukemia and lymphoma were identified by searching PubMed and EMBASE.
Outcomes of efficacy subjected to analysis were the rates of complete remission (CR) and partial
remission (PR). The safety parameters were the prevalence of adverse effects including
fever, hypotension, and acute renal failure. Meta analyses were performed using R software.
Weighted hazard ratio (HR) with 95% confidence intervals was calculated for each outcome.
Fixed or random-effects models were employed depending on the heterogeneity across the
Results: Nineteen published clinical studies with a total of 391 patients were included for the
meta-analysis. The pooled rate of complete remission was 55% (95% CI 41%-69%); the pooled
rate of partial remission was 25% (95% CI: 19%-33%). The prevalence of fever was 62% (95%
CI: 41%-79%), the hypotension was 22% (95% CI: 15%-31%), and the acute renal failure was
24% (95% CI: 16%-34%). All adverse effects were manageable and no death was reported due
Conclusion: CD19-targeted CAR-T is an effective modality in treating refractory B-cell malignancies
including leukemia and lymphoma. However, there is still a need to develop
strategies to improve the safety in its clinical use.