Consolidative Allogeneic Hematopoietic Stem Cell Transplantation Following CAR-T Cell Therapy for Acute Lymphoblastic Leukemia

Patients with refractory or relapsed (R/R) B cell acute lymphoblastic leukemia (B-ALL) have a poor prognosis and few therapy choices. Chimeric antigen receptors (CAR)-T cell therapy is a turning point in contemporary cell and gene treatments, answering an unmet need for high-risk patient treatment and bringing immunotherapies closer to cancer drugs, particularly hematologic malignancies. Many clinical trials have demonstrated that CAR-T cell treatment can reach ۷۰ to ۹۰% complete remission (CR) rates. Despite the potential benefits, it is worth noting that remission induced by CAR-T cell therapy may not last indefinitely. In fact, research indicates that between ۳۰ to ۶۰% of patients experience a relapse at some point following treatment. Due to successful remission achieved through CAR-T cell therapy, there have been doubts among researchers regarding the need for consolidative allogeneic hematopoietic stem cell transplantation (ALLO-HSCT). The use of CAR-T cell therapy as a temporary treatment or definitive solution before ALLO-HSCT is still a topic of debate due to insufficient reliable evidence. We look at the clinical evidence for consolidative ALLO-HSCT after CAR-T cell therapy, as well as the factors that may influence the benefit of ALLO-HSCT. Finally, we offer advice on assessing and managing R/R B-ALL patients receiving CAR-T cell therapy.

کلیدواژه ها:

CAR-T cells ، Hematopoietic Stem Cell Transplantation ، Acute Lymphoblastic Leukemia ، Relapse.