Effect of CAR T-cell Therapy in Acute Lymphoblastic Leukemia

Effect of CAR T-cell Therapy in Acute Lymphoblastic Leukemia
Bahare Alavi,¹ Fateme Shafiee,² Zeinab Boostani,^3,*
1. Science Faculty, Islamic Azad University of Mashhad
2. Midwifery and Nursing Faculty, Islamic Azad University of Mashhad
3. Midwifery and Nursing Faculty, Islamic Azad University of Mashhad
Introduction: Acute lymphoblastic leukemia (ALL) is one of the most common leukemias in children and the elderly. Chimeric antigen receptors (CAR) have great potential in the treatment of acute diseases. Recent advances in the immune system have led to the development of new therapies, such as the use of car Tcell, and the treatment of patients with refractory or recurrent acute lymphoblastic leukemia. In this type of treatment, immune T cells are collected from patients and designed to make car T cells and re-injected into the same patient. This type of treatment is an innovative form of treatment that puts cluster of differentiation 19 (CD19) at its most advanced. In this article we investigate the effect of therapeutic CAR T cells in the treatment of acute lymphoblastic leukemia.
Methods: We searched Pubmed,Google Scholar,SID,Cochrane databases for articles from last 5 years with treatment Car T Cells and Acute Lymphoblastic Leukemia keywords.By searching these databases 97 articles in Pubmed,234 articles in Google Scholar,10 articles were found in Chocrane. Out of a total of 341 articles, 301 were exclude after reading the headlines. Also with reading abstracts we exclude 21 articles. Finally we include 19 articles into the our study.
Results: 12 articles showed that the use of CD 19 CAR T cells therapy has been effective in the treatment of ALL disease. In 3 articles, according to clinical studies, there is a possibility of recurrence of the disease after recovery with this treatment. And in other articles no effectiveness was observed. Studies show that patients who did not respond to a CAR T cell had an abnormal composition in their CD 19 exon. An article stated that one of the concerns in CAR T cell therapy is tumor resistance. This means that exposure to therapeutic antibodies may result in a recurrence of the effect. In another article, it was stated that many efforts have been made to build suitable car T cells for the treatment of patients who may not be suitable for other treatments due to lymphobenia. Reports also indicate that CAR T cell show exceptional activity against bcell malignancies, which can indicate ALL in the early stages.
Conclusion: The results show that the use of CAR T Cells is one of the most effective and durable types of treatment for acute lymphoblastic leukemia, but due to lack of experience in this method and for more accurate and complete recovery, more studies are needed. This method requires further study. This method also increases the patient's survival time.In treatment with car t cells, environmental factors affecting the immune system's response to this treatment should be investigated. Other related treatments may also interfere with the healing process.
Keywords: Treatment, Car Tcells, Acute lymphoblastic leukemia