Ma Jin-Feng, Yan Chun-Long, Jia Xu, Zhu Hong-Jia, Yan Jia-Wei, Liu Mei-Jing, Zhang Dai-Yi, Liu Shen-Hao, Xu Nan, Zhang Hai-Guo, Ye Ling, Yu Lei, Wu De-Pei, Gong Wen-Jie, Dai Hai-Ping, Xue Sheng-Li
Jining No.1 People'hospital, Jining, China.
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Ann Hematol. 2025 Jan;104(1):57-63. doi: 10.1007/s00277-024-06132-w. Epub 2024 Dec 18.
Relapsed or refractory T-cell acute lymphoblastic leukemia/lymphoma (r/r T-ALL/LBL) are frequently aggressive and associated with unfavorable prognoses. Pan-targeted Chimeric Antigen Receptor (CAR) T-cell therapy have shown promising results in clinical trials. In recent years, CD7 CAR T-cell and CD5 CAR T-cell demonstrate effectiveness in treating r/r T-ALL/LBL patients with bone marrow infiltration. However, nearly half of r/r T-ALL/T-LBL patients are accompanied by extramedullary disease (EMD), where comprehensive data on the efficacy and safety of CAR T-cell therapy remain limited. Additionally, CD7 CAR T-cell and CD5 CAR T-cell therapy can cause severe immunodeficiency and hematologic toxicity, complicating with difficult immune reconstitution. This review provides an in-depth analysis of the safety profile and adverse events associated with CAR T-cell therapy in r/r T-ALL/LBL, with a a particular emphasis on its impact in patients with EMD.
复发或难治性T细胞急性淋巴细胞白血病/淋巴瘤（r/r T-ALL/LBL）通常具有侵袭性，预后不良。全靶向嵌合抗原受体（CAR）T细胞疗法在临床试验中已显示出有前景的结果。近年来，CD7 CAR T细胞和CD5 CAR T细胞在治疗有骨髓浸润的r/r T-ALL/LBL患者中显示出有效性。然而，近一半的r/r T-ALL/T-LBL患者伴有髓外疾病（EMD），关于CAR T细胞疗法疗效和安全性的全面数据仍然有限。此外，CD7 CAR T细胞和CD5 CAR T细胞疗法可导致严重免疫缺陷和血液学毒性，伴有免疫重建困难。本综述深入分析了r/r T-ALL/LBL中与CAR T细胞疗法相关的安全性和不良事件，特别强调其对EMD患者的影响。
