COMPARATIVE ANALYSIS OF CAR T-CELL THERAPY ALONE VERSUS CAR T-CELL THERAPY WITH STEM CELL TRANSPLANT IN BLOOD CANCERS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL OUTCOMES
Author(s)
M. Shreeram, Ph. D.1, Pradnya C, MSc2;
1Yonnova Scientific Consultancy Pvt Ltd, Shrirampur, Maharashtra, 413709, Ahmed Nagar, India, 2Yonnova Scientific Consultancy Pvt Ltd., Hinjewadi, Maan, Maharashtra, 411057, Pune, India
1Yonnova Scientific Consultancy Pvt Ltd, Shrirampur, Maharashtra, 413709, Ahmed Nagar, India, 2Yonnova Scientific Consultancy Pvt Ltd., Hinjewadi, Maan, Maharashtra, 411057, Pune, India
OBJECTIVES: Chimeric antigen receptor (CAR) T-cell therapy has significantly advanced treatment for hematologic malignancies. However, relapse following initial response remains a major clinical challenge. Consolidative stem cell transplantation (SCT) is proposed to deepen remissions and enhance long-term disease control. Thus, this systematic review and meta-analysis aimed to evaluate the clinical outcomes of CAR T-cell therapy followed by SCT compared to CAR T-cell therapy alone in patients with hematologic neoplasms.
METHODS: A comprehensive literature search was conducted across PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and grey literature sources up to September 2025. Eligible studies included randomized, nonrandomized trials, and observational studies meeting predefined PICOS criteria. Two independent reviewers screened studies and extracted data, with quality assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed using Mantel-Haenszel random-effects models in RevMan v5.4.27. Heterogeneity was assessed by Cochrane Q and I² statistics, and publication bias was evaluated with funnel plots.
RESULTS: Nine studies comprising patients treated with CAR T-cell therapy plus SCT demonstrated a significant increase in complete remission rates (OR=3.64, p=0.02), albeit with moderate-to-high heterogeneity. Consolidative SCT was also associated with a significant reduction in relapse risk (RR=0.43, 95% CI=0.23-0.81, p=0.008; I²=44%). No statistically significant differences were observed in overall survival (10 studies; RR=0.99, 95% CI=0.78-1.27, p=0.95; I²=29%), progression-free survival (RR=0.89, 95% CI=0.38-2.09, p=0.79; I²=46%), or mortality rate (RR=0.95, 95% CI=0.72-1.24, p=0.69; I²=54%).
CONCLUSIONS: Consolidative SCT following CAR T-cell therapy may improve remission depth and reduce relapse risk in hematologic malignancies but does not confer a clear overall survival benefit. These findings highlight the need for larger, well-designed prospective trials to identify patient subgroups most likely to benefit from SCT after CAR T-cell therapy.
METHODS: A comprehensive literature search was conducted across PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and grey literature sources up to September 2025. Eligible studies included randomized, nonrandomized trials, and observational studies meeting predefined PICOS criteria. Two independent reviewers screened studies and extracted data, with quality assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed using Mantel-Haenszel random-effects models in RevMan v5.4.27. Heterogeneity was assessed by Cochrane Q and I² statistics, and publication bias was evaluated with funnel plots.
RESULTS: Nine studies comprising patients treated with CAR T-cell therapy plus SCT demonstrated a significant increase in complete remission rates (OR=3.64, p=0.02), albeit with moderate-to-high heterogeneity. Consolidative SCT was also associated with a significant reduction in relapse risk (RR=0.43, 95% CI=0.23-0.81, p=0.008; I²=44%). No statistically significant differences were observed in overall survival (10 studies; RR=0.99, 95% CI=0.78-1.27, p=0.95; I²=29%), progression-free survival (RR=0.89, 95% CI=0.38-2.09, p=0.79; I²=46%), or mortality rate (RR=0.95, 95% CI=0.72-1.24, p=0.69; I²=54%).
CONCLUSIONS: Consolidative SCT following CAR T-cell therapy may improve remission depth and reduce relapse risk in hematologic malignancies but does not confer a clear overall survival benefit. These findings highlight the need for larger, well-designed prospective trials to identify patient subgroups most likely to benefit from SCT after CAR T-cell therapy.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO104
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology, STA: Genetic, Regenerative & Curative Therapies