Acute T-cell lymphoblastic leukemia: chimeric antigen receptor technology may offer a new hope

Front Immunol. 2024 Aug 13:15:1410519. doi: 10.3389/fimmu.2024.1410519. eCollection 2024.

Abstract

Acute lymphoblastic leukemia (ALL) is a prevalent malignancy affecting the hematopoietic system, encompassing both B-cell ALL (B-ALL) and T-cell ALL (T-ALL). T-ALL, characterized by the proliferation of T-cell progenitors in the bone marrow, presents significant treatment challenges, with patients often experiencing high relapse rates and poor long-term survival despite advances in chemotherapy and hematopoietic stem cell transplantation (HSCT). This review explores the pathogenesis and traditional treatment strategies of T-ALL, emphasizing the promising potential of chimeric antigen receptor (CAR) technology in overcoming current therapeutic limitations. CAR therapy, leveraging genetically modified immune cells to target leukemia-specific antigens, offers a novel and precise approach to T-ALL treatment. The review critically analyzes recent developments in CAR-T and CAR-NK cell therapies, their common targets, optimization strategies, clinical outcomes, and the associated challenges, providing a comprehensive overview of their clinical prospects in T-ALL treatment.

Keywords: CAR-NK; CAR-T; T-ALL; chimeric antigen receptor; pathogenesis.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Immunotherapy, Adoptive* / methods
  • Killer Cells, Natural / immunology
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / immunology
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / therapy
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / immunology
  • Receptors, Chimeric Antigen* / genetics
  • Receptors, Chimeric Antigen* / immunology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / transplantation

Substances

  • Receptors, Chimeric Antigen
  • Receptors, Antigen, T-Cell

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Zhejiang Medical and Health Science and Technology Plan Project (No. 2022KY1051), the Scientific Research Foundation of Zhejiang University City College (J-202103) and Natural Science Foundation of Hubei Province of China (No: 2024AFB644).