E-Book

E-Book 3rd Congress

  • The use of CAR T cell therapy in treatment of B cell malignancies
  • Mohammad Hossein Khazaee Nasirabadi,1,* Amir Hami,2
    1. Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
    2. Department of Medical Library & Information Science, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran


  • Introduction: Hematological cancers are typically treated primarily with chemotherapy, radiation, and hematopoietic stem cell transplantation (HSCT). However, improvements in immune-targeted therapy for tumors, such as chimeric antigen receptor T (CAR-T) cell therapy provided a new approach to treating cancer. So, this study aimed to examine CAR T cells' use to treat B-cell malignancies.
  • Methods: Our review's findings were derived from analyzing publications in the PubMed, Google Scholar, and Web of Science databases. We located these articles by conducting keyword searches using terms like CAR-T cell, immunotherapy, hematological malignancies, and B cell malignancies.
  • Results: One of the most crucial target antigens in B-cell malignancies, such as B-ALL and NHL (non-Hodgkin lymphoma), is CD19. Anti-CD19 CAR-T cell therapy has significantly changed the treatment landscape for B cell malignancies in recent years, producing quick and long-lasting responses in patients with R/R B-ALL and NHL. Four anti-CD19 CAR-T cell treatments have so far received FDA approval to treat R/R B-ALL and NHL. Despite the anti-CD19 CAR-T therapy's excellent clinical outcomes, CD19 antigen loss is frequently seen. In R/R BALL and NHL, alternative targets for CAR-T cell therapy have been investigated. Also, CD20 is overexpressed in over 90% of B cell lymphomas, making it an interesting target for these cancers. Over the past few years, rituximab, an anti-CD20 monoclonal antibody, has demonstrated an excellent effect on NHL. Anti-CD19 and anti-CD20 CAR-T cell combination therapy was studied to treat R/R DLBCL in order to avoid antigen escape, and it was found to be both efficient and safe. Most B cell malignancies, including B-ALL and DLBCL, have significant levels of CD22 expression, so it is an ideal target for CAR-T cell therapy in R/R B-ALL and DLBCL since it is restrictedly expressed on normal B cells while not expressed on hematopoietic stem cells. Patients with R/R B-ALL and R/R DLBCL who had not responded to prior antiCD19 CAR-T cell therapy have shown excellent success in multiple clinical trials using the anti-CD22 CAR-T cell therapy. Nevertheless, the side effects of CAR-T cell therapy, which include cytokine release syndrome (CRS), infections, cytopenia, and CRS-related coagulopathy, could be severe or even fatal.
  • Conclusion: CAR-T immunotherapy has emerged as a crucial new strategy for treating several hematological disorders due to its safety and controllability, While the efficiency, cell persistence, and side effects become barriers to the widespread application of this strategy.
  • Keywords: CAR-T cell, immunotherapy, hematological malignancies, B cell malignancies