CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?

<b>Background</b>: Patients with refractory and relapsed acute myeloid leukemia (R/R AML) face a dismal prognosis. CAR-T therapy has emerged as a potential treatment option. This study assesses the available clinical evidence on CAR-T in R/R AML, focusing on safety and efficacy outcomes....

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Main Authors: Pilar Lloret-Madrid, Pedro Chorão, Manuel Guerreiro, Pau Montesinos
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/6/322
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author Pilar Lloret-Madrid
Pedro Chorão
Manuel Guerreiro
Pau Montesinos
author_facet Pilar Lloret-Madrid
Pedro Chorão
Manuel Guerreiro
Pau Montesinos
author_sort Pilar Lloret-Madrid
collection DOAJ
description <b>Background</b>: Patients with refractory and relapsed acute myeloid leukemia (R/R AML) face a dismal prognosis. CAR-T therapy has emerged as a potential treatment option. This study assesses the available clinical evidence on CAR-T in R/R AML, focusing on safety and efficacy outcomes. <b>Methods</b>: We included studies on CAR-T therapy for R/R AML published from June 2014 to January 2025. Data on patient and disease characteristics, CAR-T constructs, response rates, post-CAR-T allogeneic HSCT (allo-HSCT), and safety outcomes were analyzed. <b>Results</b>: Twenty-five CAR-T clinical trials involving 296 patients were identified. The most frequently targeted antigens were CD33, CD123, and CLL-1, while CD7, CD19, NKG2D, and CD38 were also explored. Responses were heterogeneous and often short-lived when not consolidated with allo-HSCT. Cytokine release syndrome and neurotoxicity were generally low grade and manageable. Prolonged and severe myelosuppression was a frequent limiting toxicity, often requiring allo-HSCT to restore hematopoiesis. Disease progression was the leading cause of death, followed by infections. <b>Conclusions</b>: CAR-T cell therapy may represent a feasible therapeutic strategy, particularly as bridging to allo-HSCT to mitigate myelotoxicity and improve long-term outcomes. Nevertheless, it remains in the early stages of development and faces significant efficacy and safety challenges that must be addressed in future trials to enable the expansion of this promising therapeutic approach for a population with high unmet medical needs.
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spelling doaj-art-bc2d447dcda64100bf14b0b3e2e9a3262025-08-20T03:24:32ZengMDPI AGCurrent Oncology1198-00521718-77292025-05-0132632210.3390/curroncol32060322CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?Pilar Lloret-Madrid0Pedro Chorão1Manuel Guerreiro2Pau Montesinos3Hematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, SpainHematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain<b>Background</b>: Patients with refractory and relapsed acute myeloid leukemia (R/R AML) face a dismal prognosis. CAR-T therapy has emerged as a potential treatment option. This study assesses the available clinical evidence on CAR-T in R/R AML, focusing on safety and efficacy outcomes. <b>Methods</b>: We included studies on CAR-T therapy for R/R AML published from June 2014 to January 2025. Data on patient and disease characteristics, CAR-T constructs, response rates, post-CAR-T allogeneic HSCT (allo-HSCT), and safety outcomes were analyzed. <b>Results</b>: Twenty-five CAR-T clinical trials involving 296 patients were identified. The most frequently targeted antigens were CD33, CD123, and CLL-1, while CD7, CD19, NKG2D, and CD38 were also explored. Responses were heterogeneous and often short-lived when not consolidated with allo-HSCT. Cytokine release syndrome and neurotoxicity were generally low grade and manageable. Prolonged and severe myelosuppression was a frequent limiting toxicity, often requiring allo-HSCT to restore hematopoiesis. Disease progression was the leading cause of death, followed by infections. <b>Conclusions</b>: CAR-T cell therapy may represent a feasible therapeutic strategy, particularly as bridging to allo-HSCT to mitigate myelotoxicity and improve long-term outcomes. Nevertheless, it remains in the early stages of development and faces significant efficacy and safety challenges that must be addressed in future trials to enable the expansion of this promising therapeutic approach for a population with high unmet medical needs.https://www.mdpi.com/1718-7729/32/6/322acute myeloid leukemiarelapsed or refractory AMLCAR-T cell therapy
spellingShingle Pilar Lloret-Madrid
Pedro Chorão
Manuel Guerreiro
Pau Montesinos
CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
Current Oncology
acute myeloid leukemia
relapsed or refractory AML
CAR-T cell therapy
title CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
title_full CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
title_fullStr CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
title_full_unstemmed CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
title_short CAR-T Cell Therapy for Acute Myeloid Leukemia: Where Do We Stand Now?
title_sort car t cell therapy for acute myeloid leukemia where do we stand now
topic acute myeloid leukemia
relapsed or refractory AML
CAR-T cell therapy
url https://www.mdpi.com/1718-7729/32/6/322
work_keys_str_mv AT pilarlloretmadrid cartcelltherapyforacutemyeloidleukemiawheredowestandnow
AT pedrochorao cartcelltherapyforacutemyeloidleukemiawheredowestandnow
AT manuelguerreiro cartcelltherapyforacutemyeloidleukemiawheredowestandnow
AT paumontesinos cartcelltherapyforacutemyeloidleukemiawheredowestandnow