CAR-T cells and allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia

Immunotherapy. 2017 Oct;9(13):1115-1125. doi: 10.2217/imt-2017-0072.

Abstract

Relapsed/refractory acute lymphoblastic leukemia (ALL) has a low remission rate after chemotherapy, a high relapse rate and poor long-term survival even when allogeneic hematopoietic stem cell transplantation (allo-HSCT) is performed. Chimeric antigen receptors redirected T cells (CAR-T cells) can enhance disease remission with a favorable outcome for relapsed/refractory ALL, though some cases quickly relapsed after CAR-T cell treatment. Thus, treatment with CAR-T cells followed by allo-HSCT may be the best way to treat relapsed/refractory ALL. In this review, we first discuss the different types of CAR-T cells. We then discuss the treatment of relapsed/refractory ALL using only CAR-T cells. Finally, we discuss the use of CAR-T cells, followed by allo-HSCT, for the treatment of relapsed/refractory ALL.

Keywords: B-cell acute lymphoblastic leukemia; CAR-T cells; allogeneic hematopoietic stem cell transplantation; relapsed/refractory.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, Neoplasm / immunology
  • B-Lymphocytes / pathology*
  • Cancer Vaccines / immunology*
  • Genetic Engineering
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunotherapy, Adoptive / methods*
  • Interleukin-5 / genetics
  • Lymphocyte Activation
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Recurrence
  • T-Lymphocytes / physiology*
  • T-Lymphocytes / transplantation
  • Transplantation, Homologous

Substances

  • Antigens, Neoplasm
  • Cancer Vaccines
  • Interleukin-5