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Efficacy and safety of CD19 CAR-T cell therapy for acute lymphoblastic leukemia patients relapsed after allogeneic hematopoietic stem cell transplantation

  • Progress in Hematology
  • Prevention and management of relapse after allogeneic hematopoietic cell transplantation in hematological malignancies
  • Published:
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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective therapy for B-cell acute lymphoblastic leukemia (B-ALL). Although allo-HSCT can be curative for some B-ALL patients, relapse still occurs in some patients following allo-HSCT. Conventional chemotherapies show poor efficacy in B-ALL patients who have relapsed following allo-HSCT. In the past decade, chimeric antigen receptor T-cell (CAR-T) therapy has shown to be efficacious for B-ALL patients. In particular, autologous CD19 CAR-T therapy results in a high remission rate. However, there are challenges in the use of CD19 CAR-T therapy for B-ALL patients who have relapsed following allo-HSCT, including the selection of CAR-T cell source for manufacturing, post-CAR-T graft-versus-host disease (GVHD) risk, maintenance of long-term efficacy after remission through CAR-T therapy, and whether a consolidative second transplant is needed. In this review, we describe the current status of CAR-T therapy for B-ALL patients who have relapsed following allo-HSCT, the advantages and disadvantages of various CAR-T cell sources, the characteristics and management of GVHD following CAR-T therapy, and the risk factors that may affect long-term efficacy.

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  1. Pei-hua Lu and Kai-yan Liu have contributed equally to this work.

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  1. Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China

    Xing-yu Cao, Jing-jing Li & Pei-hua Lu

  2. Beijing Lu Daopei Institute of Hematology, Beijing, China

    Xing-yu Cao, Jing-jing Li, Pei-hua Lu & Kai-yan Liu

  3. Peking University People’s Hospital, Beijing, China

    Kai-yan Liu

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Cao, Xy., Li, Jj., Lu, Ph. et al. Efficacy and safety of CD19 CAR-T cell therapy for acute lymphoblastic leukemia patients relapsed after allogeneic hematopoietic stem cell transplantation. Int J Hematol 116, 315–329 (2022). https://doi.org/10.1007/s12185-022-03398-6

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