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CAR T-cell immunotherapy: a powerful weapon for fighting hematological B-cell malignancies

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Abstract

The current standard of care in hematological malignancies has brought considerable clinical benefits to patients. However, important bottlenecks still limit optimal achievements following a current medical practice. The genetic complexity of the diseases and the heterogeneity of tumor clones cause difficulty in ensuring long-term efficacy of conventional treatments for most hematological disorders. Consequently, new treatment strategies are necessary to improve clinical outcomes. Chimeric antigen receptor T-cell (CAR T) immunotherapy opens a new path for targeted therapy of hematological malignancies. In this review, through a representative case study, we summarize the current experience of CAR T-cell therapy, the management of common side effects, the causative mechanisms of therapy resistance, and new strategies to improve the efficacy of CAR T-cell therapy.

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Acknowledgements

This study was funded by the State Key Laboratory of Medical Genomics, the Double First-Class Project (No. WF510162602) from the Ministry of Education, the Shanghai Collaborative Innovation Program on Regenerative Medicine and Stem Cell Research (No. 2019CXJQ01), the Overseas Expertise Introduction Project for Discipline Innovation (111 Project; No. B17029), the National Natural Science Foundation of China (Nos. 82070227, 81861148030, 81670147, and 81970189), Clinical Research Plan of SHDC (No. SHDC2020CR2066B), the Shanghai Major Project for Clinical Medicine (No. 2017ZZ01002), the Innovative Research Team of High-level Local Universities in Shanghai, National Science and Technology Major Project (No. 2019ZX09301139).

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Authors and Affiliations

  1. State Key Laboratory of Medical Genomics, Shanghai Institute of Haematology, National Research Centre for Translational Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Jian-Qing Mi, Jie Xu, Weili Zhao, Zhu Chen & Saijuan Chen

  2. Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Jie Xu & J. Joseph Melenhorst

  3. Immunotherapy Research Centre for Hematologic Diseases of Hubei Province, Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jianfeng Zhou

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  1. Jian-Qing Mi
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  4. Weili Zhao
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  5. Zhu Chen
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Correspondence to J. Joseph Melenhorst or Saijuan Chen.

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Jianqing Mi, Jie Xu, Jianfeng Zhou, Weili Zhao, Zhu Chen, J. Joseph Melenhorst, and Saijuan Chen involved in this review writing declare that they have no financial conflicts of interest. This manuscript is a review article and does not contain research protocols requiring approval by the relevant institutional review board or ethics committee.

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Mi, JQ., Xu, J., Zhou, J. et al. CAR T-cell immunotherapy: a powerful weapon for fighting hematological B-cell malignancies. Front. Med. 15, 783–804 (2021). https://doi.org/10.1007/s11684-021-0904-z

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