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CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects

The currently available treatment for acute lymphoblastic leukemia (ALL) is mainly dependent on the combination of chemotherapy, steroids, and allogeneic stem cell transplantation. However, refractoriness and relapse (R/R) after initial complete remission may reach up to 20% in pediatrics. This perc...

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Autores principales: Almaeen, Abdulrahman H., Abouelkheir, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604728/
https://www.ncbi.nlm.nih.gov/pubmed/37893067
http://dx.doi.org/10.3390/biomedicines11102693
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author Almaeen, Abdulrahman H.
Abouelkheir, Mohamed
author_facet Almaeen, Abdulrahman H.
Abouelkheir, Mohamed
author_sort Almaeen, Abdulrahman H.
collection PubMed
description The currently available treatment for acute lymphoblastic leukemia (ALL) is mainly dependent on the combination of chemotherapy, steroids, and allogeneic stem cell transplantation. However, refractoriness and relapse (R/R) after initial complete remission may reach up to 20% in pediatrics. This percentage may even reach 60% in adults. To overcome R/R, a new therapeutic approach was developed using what is called chimeric antigen receptor-modified (CAR) T-cell therapy. The Food and Drug Administration (FDA) in the United States has so far approved four CAR T-cells for the treatment of ALL. Using this new therapeutic strategy has shown a remarkable success in treating R/R ALL. However, the use of CAR T-cells is expensive, has many imitations, and is associated with some adverse effects. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are two common examples of these adverse effects. Moreover, R/R to CAR T-cell therapy can take place during treatment. Continuous development of this therapeutic strategy is ongoing to overcome these limitations and adverse effects. The present article overviews the use of CAR T-cell in the treatment of ALL, summarizing the results of relevant clinical trials and discussing future prospects intended to improve the efficacy of this therapeutic strategy and overcome its limitations.
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spelling pubmed-106047282023-10-28 CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects Almaeen, Abdulrahman H. Abouelkheir, Mohamed Biomedicines Review The currently available treatment for acute lymphoblastic leukemia (ALL) is mainly dependent on the combination of chemotherapy, steroids, and allogeneic stem cell transplantation. However, refractoriness and relapse (R/R) after initial complete remission may reach up to 20% in pediatrics. This percentage may even reach 60% in adults. To overcome R/R, a new therapeutic approach was developed using what is called chimeric antigen receptor-modified (CAR) T-cell therapy. The Food and Drug Administration (FDA) in the United States has so far approved four CAR T-cells for the treatment of ALL. Using this new therapeutic strategy has shown a remarkable success in treating R/R ALL. However, the use of CAR T-cells is expensive, has many imitations, and is associated with some adverse effects. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are two common examples of these adverse effects. Moreover, R/R to CAR T-cell therapy can take place during treatment. Continuous development of this therapeutic strategy is ongoing to overcome these limitations and adverse effects. The present article overviews the use of CAR T-cell in the treatment of ALL, summarizing the results of relevant clinical trials and discussing future prospects intended to improve the efficacy of this therapeutic strategy and overcome its limitations. MDPI 2023-10-02 /pmc/articles/PMC10604728/ /pubmed/37893067 http://dx.doi.org/10.3390/biomedicines11102693 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Almaeen, Abdulrahman H.
Abouelkheir, Mohamed
CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title_full CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title_fullStr CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title_full_unstemmed CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title_short CAR T-Cells in Acute Lymphoblastic Leukemia: Current Status and Future Prospects
title_sort car t-cells in acute lymphoblastic leukemia: current status and future prospects
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604728/
https://www.ncbi.nlm.nih.gov/pubmed/37893067
http://dx.doi.org/10.3390/biomedicines11102693
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