ABSTRACT Objectives Comparisons of safety and efficacy of Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) following complete remission (CR) achieved by Chimeric antigen receptor T (CAR‐T) cell therapy versus chemotherapy for B‐cell acute lymphoblastic leukemia (B‐ALL) have not been fully discussed. Methods We performed a comparison of transplant outcomes in 443 consecutive B‐ALL patients who received allo‐HSCT after achieving CR with CAR‐T therapy ( n = 50) or with chemotherapy ( n = 393). The median follow‐up time was 30 months (range: 1–62 months). Results The CAR‐T group had a lower incidence of chronic graft‐versus‐host disease (30.9% vs. 44.0%, p = 0.020). We also found that the incidence of veno‐occlusive disease was higher in the CAR‐T group compared to the chemotherapy group (4% vs. 0.5%; p = 0.003). The study revealed that both the CAR‐T and chemotherapy groups exhibited comparable overall survival (90.9% vs. 94.6%, p = 0.158) and relapse incidences (9.1% vs. 8.4%, p = 0.513). However, incidences of non‐relapse mortality after transplantation were higher in the CAR‐T group (10.9% vs. 4.3%, p = 0.016), and leukemia‐free survival was lower in the CAR‐T group compared to the chemotherapy group (80.0% vs. 86.8%, p = 0.040). Conclusions Our data indicate that, in B‐ALL patients, most treatment‐related complications and survival were comparable between CAR T‐cell therapy and chemotherapy followed by allo‐HSCT.
Wu et al. (Tue,) studied this question.