Advances in the development of chimeric antigen receptor-T-cell therapy in B-cell acute lymphoblastic leukemia
10.1097/CM9.0000000000000638
- Author:
Zhang XIAN
1
;
Li JING-JING
;
Lu PEI-HUA
Author Information
1. Department of Hematology
- Keywords:
Chimeric antigen receptor T-cell;
B-cell acute lymphoblastic leukemia;
Complete remission;
Cytokine release syndrome;
Relapse;
Transplantation
- From:
Chinese Medical Journal
2020;133(4):474-482
- CountryChina
- Language:Chinese
-
Abstract:
CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy is effective in refractory/relapsed (R/R) B-cell acute lymphoblastic leukemia (B-ALL).This review focuses on achievements,current obstacles,and future directions in CAR-T research.A high complete remission rate of 68 ％ to 93％ could be achieved after and-CD19 CAR-T treatment for B-ALL Cytokine release syndrome and CAR-T-related neurotoxicity could be managed.In view of difficulties collecting autologous lymphocytes,universal CAR-T is a direction to explore.Regarding the high relapse rate after anti-CD19 CAR-T therapy,the main solutions have been developing new targets including CD22 CAR-T,or CD19/CD22 dual CAR-T.Additionally,some studies showed that bridging into transplant postCAR-T could improve leukemia-free survival.Some patients who did not respond to CAR-T therapy were found to have an abnormal conformation of the CD 19 exon or trogocytosis.Anti-CD19 CAR-T therapy for R/R B-ALL is effective.From individual to universal CAR-T,from one target to multi-targets,CAR-T-cell has a chance to be off the shelf in the future.
