Chimeric Antigen Receptor T-Cells in B-Acute Lymphoblastic Leukemia: State of the Art and Future Directions

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Abstract

Use of adoptive T-cell therapy modified with chimeric antigen receptor (CAR-T) has revolutionized treatment of patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL). CAR-T cells directed against CD19 antigen have produced response rates as high as 90% in clinical trials for r/r B-ALL. Despite high rates of complete remissions, the durability of responses has been sub-optimal with frequent relapses, especially in adult B-ALL population. Systemic toxicities from CAR-T therapy and standardization of toxicities grading and management is another major hurdle in the development of CAR-T field. In this review, we discuss the latest evidence of CAR-T therapy in B-ALL, potential mechanisms of relapse and barriers to CAR-T cell therapy in B-ALL. We also debate the role of allogeneic hematopoietic stem cell transplant (allo-HCT) post CAR-T therapy.

Original languageEnglish (US)
Article number1594
JournalFrontiers in Oncology
Volume10
DOIs
StatePublished - Aug 26 2020

Keywords

  • B-ALL
  • CAR-T therapy
  • acute lymphoblastic leukemia
  • allogeneic transplant after CAR-T therapy
  • chimeric antigen receptor
  • relapse after CAR-T therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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