CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA
Treatment of refractory and relapsed (R/R) B acute lymphoblastic leukemia (B-ALL) is an unmet medical need in both children and adults. Studies carried out in the last two decades have shown that autologous T cells engineered to express a chimeric antigen receptor (CAR-T) represent an effective tec...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-01-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
| Online Access: | https://mjhid.org/mjhid/article/view/5560 |
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| author | Ugo Testa Simona Sica Elvira Pelosi Germana Castelli Giuseppe Leone |
| author_facet | Ugo Testa Simona Sica Elvira Pelosi Germana Castelli Giuseppe Leone |
| author_sort | Ugo Testa |
| collection | DOAJ |
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Treatment of refractory and relapsed (R/R) B acute lymphoblastic leukemia (B-ALL) is an unmet medical need in both children and adults. Studies carried out in the last two decades have shown that autologous T cells engineered to express a chimeric antigen receptor (CAR-T) represent an effective technique for treating these patients. Antigens expressed on B-cells, such as CD19, CD20, and CD22, represent targets suitable for treating patients with R/R B-ALL. CD19 CAR-T cells induce a high rate (80-90%) of complete remissions in both pediatric and adult R/R B-ALL patients. However, despite this impressive rate of responses, about half of responding patients relapse within 1-2 years after CAR-T cell therapy. Allo-HSCT after CAR-T cell therapy might consolidate the therapeutic efficacy of CAR-T and increase long-term outcomes; however, not all the studies that have adopted allo-HSCT as a consolidative treatment strategy have shown a benefit deriving from transplantation.
For B-ALL patients who relapse early after allo-HSCT or those with insufficient T-cell numbers for an autologous approach, using T cells from the original stem cell donor offers the opportunity for the successful generation of CAR-T cells and for an effective therapeutic approach.
Finally, recent studies have introduced allogeneic CAR-T cells generated from healthy donors or unmatched, which are opportunely manipulated with gene editing to reduce the risk of immunological incompatibility, with promising therapeutic effects.
Keywords: CAR T; Acute Lymphoid Leukemia; Allogeneic CAR-T; Autologous CAR-T.
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| format | Article |
| id | doaj-art-6906bae33f5842158b95ccf235573940 |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-6906bae33f5842158b95ccf2355739402025-01-02T22:43:02ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062024-01-0116110.4084/MJHID.2024.010CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIAUgo Testa0Simona Sica1Elvira Pelosi2Germana Castelli3Giuseppe Leone4ISSUniversità Cattolica del Sacro Cuore. RomaISSISS. Roma. Italy.Università Cattolica Treatment of refractory and relapsed (R/R) B acute lymphoblastic leukemia (B-ALL) is an unmet medical need in both children and adults. Studies carried out in the last two decades have shown that autologous T cells engineered to express a chimeric antigen receptor (CAR-T) represent an effective technique for treating these patients. Antigens expressed on B-cells, such as CD19, CD20, and CD22, represent targets suitable for treating patients with R/R B-ALL. CD19 CAR-T cells induce a high rate (80-90%) of complete remissions in both pediatric and adult R/R B-ALL patients. However, despite this impressive rate of responses, about half of responding patients relapse within 1-2 years after CAR-T cell therapy. Allo-HSCT after CAR-T cell therapy might consolidate the therapeutic efficacy of CAR-T and increase long-term outcomes; however, not all the studies that have adopted allo-HSCT as a consolidative treatment strategy have shown a benefit deriving from transplantation. For B-ALL patients who relapse early after allo-HSCT or those with insufficient T-cell numbers for an autologous approach, using T cells from the original stem cell donor offers the opportunity for the successful generation of CAR-T cells and for an effective therapeutic approach. Finally, recent studies have introduced allogeneic CAR-T cells generated from healthy donors or unmatched, which are opportunely manipulated with gene editing to reduce the risk of immunological incompatibility, with promising therapeutic effects. Keywords: CAR T; Acute Lymphoid Leukemia; Allogeneic CAR-T; Autologous CAR-T. https://mjhid.org/mjhid/article/view/5560 |
| spellingShingle | Ugo Testa Simona Sica Elvira Pelosi Germana Castelli Giuseppe Leone CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA Mediterranean Journal of Hematology and Infectious Diseases |
| title | CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA |
| title_full | CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA |
| title_fullStr | CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA |
| title_full_unstemmed | CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA |
| title_short | CAR-T CELL THERAPY IN B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA |
| title_sort | car t cell therapy in b cell acute lymphoblastic leukemia |
| url | https://mjhid.org/mjhid/article/view/5560 |
| work_keys_str_mv | AT ugotesta cartcelltherapyinbcellacutelymphoblasticleukemia AT simonasica cartcelltherapyinbcellacutelymphoblasticleukemia AT elvirapelosi cartcelltherapyinbcellacutelymphoblasticleukemia AT germanacastelli cartcelltherapyinbcellacutelymphoblasticleukemia AT giuseppeleone cartcelltherapyinbcellacutelymphoblasticleukemia |