Chimeric antigen receptor T-cell therapy (CAR-T) targeting CD19 has transformed the management of relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL), with the US Food and Drug Administration approval of tisagenlecleucel for pediatric/young adult patients and brexucabtagene autoleucel for adults. Efficacy is contingent upon several factors including disease burden. Emerging data suggest that bridging therapy, lymphodepletion, and, for some patients, consolidation therapy have an important role in the success of treatment. Furthermore, strategies to define and manage immunotoxic side effects including hematotoxicity is critical to safe delivery. Advancements in CAR-T design beyond CD19 represent an ongoing therapeutic evolution. Overall, CAR-T signifies a paradigm shift in B-ALL management, with the potential for improved remission and survival in a historically challenging patient population.
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Acute Lymphoblastic Leukemia|
April 3, 2025
The present and future of CAR T-cell therapy for adult B-cell ALL
Alexandros Rampotas,
Alexandros Rampotas
1Department of Haematology, Cancer Institute, University College London, London, United Kingdom
2Department of Haematology, University College London Hospital National Health Service Foundation Trust, London, United Kingdom
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Claire Roddie
Claire Roddie
1Department of Haematology, Cancer Institute, University College London, London, United Kingdom
2Department of Haematology, University College London Hospital National Health Service Foundation Trust, London, United Kingdom
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Blood (2025) 145 (14): 1485–1497.
Article history
Submitted:
April 5, 2024
Accepted:
August 21, 2024
First Edition:
September 24, 2024
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Citation
Alexandros Rampotas, Claire Roddie; The present and future of CAR T-cell therapy for adult B-cell ALL. Blood 2025; 145 (14): 1485–1497. doi: https://doi.org/10.1182/blood.2023022922
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April 3 2025
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