[How I manage relapsed/refractory B-cell acute lymphoblastic leukemia patients treated with CD19 CAR- T cells...

Remission rate of newly diagnosed B-cell acute lymphoblastic leukemia (B-ALL) based on chemotherapy was high; however, recurrence and refractory diseases still affect long-term survival, especially in adult patients. Chimeric antigen receptor T-cell (CAR-T cell) therapy is an important salvage treatment for patients with relapsed/refractory B-ALL, and it significantly improves the response rate, response quality, and survival of such patients. The mechanism and adverse reactions of CAR-T cellular therapy differed from those of traditional chemotherapy, molecular targeted drugs, antibody drugs, etc. Further, it has unique and, in some cases, more serious adverse reactions, despite its relatively high remission rate. Strengthening the full-process management of CAR-T cellular therapy helps achieve higher efficacy with better safety. The article takes one patient with relapsed/refractory B-ALL treated with CD19 CAR-T at our center as an example, and introduces the full-process management strategy of CAR-T cellular therapy, including patient selection, bridging therapy, lymphodepletion treatment, and adverse reaction management.