[CAR T cell therapy in acute lymphoblastic leukemia].

Abstract

Modern immunotherapy in the form of T‑cell-based CD19-targeted approaches, such as the approved bispecific T‑cell engager (BiTE antibody) blinatumomab and chimeric antigen receptor T cells (CAR T cells) with the approved products tisagenlecleucel and brexucabtagene autoleucel has revolutionized the treatment of B‑precursor acute lymphoblastic leukemia (ALL). The pivotal clinical trials for the approval, including follow-up studies as well as the now available real-world data outside of these trials, showed that CAR-T cell therapy provides an effective treatment option for patients with relapsed and refractory B‑precursor ALL after chemotherapy, improving an otherwise poor prognosis. In addition to the therapeutic response, side effects of CAR-T cell therapy and their clinical management are discussed. Furthermore, resistance mechanisms are discussed and an outlook on further development is given. The T‑precursor ALL remains a challenge due to its immunological complexity but new developments in CAR-T cell treatment approaches targeting CD5 and CD7 show that progress is also being made in this area.