Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
Am J Hematol. 2019 May;94(S1):S24-S27. doi: 10.1002/ajh.25442. Epub 2019 Mar 22.
Chimeric antigen receptor (CAR) modified T cells targeted to CD19 have resulted in unprecedented remission rates for adult and pediatric patients with relapsed and refractory B cell acute lymphoblastic leukemia (ALL). With regulatory approval for tisagenlecleucel and many other agents under active investigation, the use of CAR T cells for ALL continues to expand. While some remissions from anti-CD19 CAR T cells are durable without a consolidative allogeneic stem cell transplantation, CD19 positive and negative relapses remain a significant concern fueling investigations into the biology of CAR T cell persistence and the development of CARTs that target more than 1 antigen. The treatment related toxicities of cytokine release syndrome and neurologic events are potentially life threatening but recent advances have improved understanding and management strategies. This review summarizes outcomes for patients with ALL treated with CD19-CAR T cells while exploring the field's challenges and future directions.
嵌合抗原受体（CAR）修饰的 T 细胞靶向 CD19，为成人和儿童复发/难治性 B 细胞急性淋巴细胞白血病（ALL）患者带来了前所未有的缓解率。随着 tisagenlecleucel 等药物获得监管批准，以及许多其他药物正在积极研究中，CAR T 细胞在 ALL 中的应用不断扩大。虽然有些抗 CD19 CAR T 细胞的缓解是持久的，无需巩固性异基因干细胞移植，但 CD19 阳性和阴性复发仍然是一个重大问题，这推动了对 CAR T 细胞持久性生物学的研究，并开发了针对超过 1 种抗原的 CART。细胞因子释放综合征和神经事件等治疗相关毒性具有潜在的致命性，但最近的进展提高了我们对其的理解和管理策略。本综述总结了接受 CD19-CAR T 细胞治疗的 ALL 患者的结果，同时探讨了该领域的挑战和未来方向。
