[CAR-T cell therapy for acute lymphoblastic leukemia: current landscape and novel developments]

Advances in chemotherapy have improved survival rates for acute lymphoblastic leukemia (ALL); however, further intensification of chemotherapy is no longer feasible, and novel therapies are required for relapsed or refractory disease. Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 has demonstrated high remission rates and significantly transformed treatment strategies, although toxicity, relapse, and limited indications remain ongoing challenges. This review summarizes the efficacy and safety of tisagenlecleucel, which is approved in Japan, as well as CAR-T products available overseas. It also discusses prognostic factors (such as pre-infusion tumor burden, prior treatment history, and genetic abnormalities), post-infusion biomarkers, and post-treatment management. Furthermore, it outlines the current status and challenges of novel therapies under development, including dual-targeting CAR-T cells and CAR-T therapy for T-cell ALL.