With the exploitation of adoptive immunotherapies, the outcomes of patients with relapsed and refractory B cell hematologic malignancies have seen drastic improvements. To this end, a paradigm shift away from toxic and ineffective chemotherapies has been visible with the FDA approval of genetically modified autologous T cell products designed to express chimeric antigen receptors able to specifically recognize the CD19 cell surface marker. To date, CAR-T cells have two FDA-approved indications including relapsed or refractory acute lymphoblastic leukemia in children and young adults as well as large B cell lymphoma that is relapsed and/or refractory to two prior therapies. This chapter will discuss the utility of this therapy in B-ALL, common toxicities and their management, relationship to other therapies such as stem cell transplantation, and future directions.
Keywords: Acute lymphoblastic leukemia; B cell; CAR-T; CD19; Chimeric antigen receptor.
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