Chorão Pedro, Lloret Pilar, Montesinos Pau, Guerreiro Manuel
Hematology Department, Hospital Universitari i Politècnic La Fe, València, Spain.
Hematology Research Group, Institut d'Investigació Sanitària La Fe, València, Spain.
Expert Rev Anticancer Ther. 2025 Aug;25(8):939-948. doi: 10.1080/14737140.2025.2515981. Epub 2025 Jun 8.
CAR-T therapies for relapsed or refractory (r/r) T-cell lymphoblastic leukemia/lymphoma (T-LL/L) faces challenges, with most clinical studies conducted in small, dispersed cohorts and often reviewed alongside preclinical studies. This review focuses exclusively on clinical studies, evaluating CAR constructs, safety and efficacy.
A systematic review was conducted of databases, clinical trial registries, and abstracts from conferences (June 2014 to June 2024). Preclinical studies and studies lacking clinical details were excluded. Data on patient demographics, CAR-T characteristics, response rates, survival, and adverse events were analyzed.
Eleven CAR-T constructs targeting CD7 and two targeting CD5 were identified. Complete remission (CR/CRi) rates ranged from 55% to 100%, exceeding 80% in most studies. Relapse, often in extramedullary sites, ranged from 7% to 66%. Cytokine release syndrome and neurotoxicity were generally manageable. GVHD incidence varied (none to 60%), primarily in allogeneic CAR-T recipients. Infections contributed to 6-38% of treatment-related mortality.
CAR-T therapy achieves high response rates in r/r T-LL/L and may serve as a bridge to allogeneic transplantation. However, the short follow-up and the duration of responses remain concerns, and challenges endure, including GVHD, immune recovery and infection control. Standardized reporting is crucial to optimize therapy outcomes and safety in future trials.
PROSPERO (CRD420251024662).
嵌合抗原受体T细胞（CAR-T）疗法用于复发或难治性（r/r）T细胞淋巴母细胞白血病/淋巴瘤（T-LL/L）面临挑战，大多数临床研究在小规模、分散的队列中进行，且常与临床前研究一起综述。本综述专门聚焦于临床研究，评估CAR构建体、安全性和疗效。
对数据库、临床试验注册库以及会议摘要（2014年6月至2024年6月）进行系统综述。排除临床前研究和缺乏临床细节的研究。分析患者人口统计学、CAR-T特征、缓解率、生存率和不良事件的数据。
确定了11种靶向CD7的CAR-T构建体和2种靶向CD5的构建体。完全缓解（CR/CRi）率在55%至100%之间，大多数研究超过80%。复发通常发生在髓外部位，范围为7%至66%。细胞因子释放综合征和神经毒性一般可控。移植物抗宿主病（GVHD）发生率各不相同（从无到60%），主要见于接受同种异体CAR-T治疗的患者。感染导致6%至38%的治疗相关死亡。
CAR-T疗法在r/r T-LL/L中取得了高缓解率，可作为异基因移植的桥梁。然而，随访时间短和缓解持续时间仍是问题，挑战依然存在，包括GVHD、免疫恢复和感染控制。标准化报告对于优化未来试验的治疗结果和安全性至关重要。
PROSPERO（CRD420251024662）
