CAR-T cell exhaustion in B cell lymphoma: Current status, mechanisms, and potential solutions

Chimeric antigen receptor T cell (CAR-T) therapy represents a revolutionary approach in the treatment of refractory or relapsed hematological malignancies including lymphoma. Despite its efficacy, a significant subset of patients experiences disease progression or relapse after initial response, and CAR-T cell exhaustion in the tumor microenvironment (TME) is a critical cause for the unsatisfactory responses. This review discusses the current situation of CAR-T therapies in the clinical treatment of lymphoma patients, the mechanisms of CAR-T cell exhaustion, and potential strategies to overcome CAR-T cell exhaustion, thereby bringing hope to improve therapeutic outcomes for lymphoma patients.