-Rearranged Acute Leukemia with t(4;11)(q21;q23)-Current Treatment Options. Is There a Role for CAR-T Cell Therapy?

The () gene, located on chromosome 11q23, is involved in chromosomal translocations in a subtype of acute leukemia, which represents approximately 10% of acute lymphoblastic leukemia and 2.8% of acute myeloid leukemia cases. These translocations form fusions with various genes, of which more than 80 partner genes for have been identified. The most recurrent fusion partner in rearrangements (-r) is , mapping at chromosome 4q21, accounting for approximately 36% of -r leukemia and particularly prevalent in -r acute lymphoblastic leukemia (ALL) cases (57%). -r leukemia is associated with a sudden onset, aggressive progression, and notoriously poor prognosis in comparison to non--r leukemias. Despite modern chemotherapeutic interventions and the use of hematopoietic stem cell transplantations, infants, children, and adults with -r leukemia generally have poor prognosis and response to these treatments. Based on the frequency of patients who relapse, do not achieve complete remission, or have brief event-free survival, there is a clear clinical need for a new effective therapy. In this review, we outline the current therapy options for -r patients and the potential application of CAR-T therapy.