[CAR-T therapy in relapsed or refractory B-cell acute lymphoblastic leukemia: a new treatment paradigm]

The therapy of patients with acute lymphoblastic leukemia (ALL) in the latter has achieved significant progress by increasing the complete remission (CR) rate, re-binding allogeneic transplantation to patients with high-risk disease and/or not in MRD-negative CR. The flip side of these successes is the more difficult management for patients who are refractory to modern treatment regimens or who relapse. Historically, it was necessary to aim for a CR and consolidate the result with allogeneic transplantation, an option available only to young and fit patients. Introduction of CAR therapy T seems to undermine this dogma by allowing to offer a lasting therapeutic perspective even for elderly patients who do not obtain a clinical response with second line therapy.