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Abstract

The use of chimeric antigen receptor T (CAR-T) cells in the treatment of haematological malignancies, particularly relapsed/refractory (R/R) B cell malignancies, has resulted in quite a high success rate. The most popular CAR-T cell therapy targets currently are CD19 and B-cell maturation antigen (BCMA), though many other innovative therapeutic targets are being investigated. According to the National Cancer Institute BCMA is defined as an antigen found on the surfaces of B cells and is overexpressed on malignant plasma cells. Additionally, CD19 controls B cells in an antigen receptor-dependent way and is produced throughout the B cell differentiation process, particularly during the malignant transformation of B cells (Zheng et al., 2020). Researchers are therefore attracted to CD19 as a potential target. However, side effects from CAR-T cell therapy, such as neurotoxicity and cytokine release syndrome (CRS) exist and could be severe or even fatal. Additionally, after receiving CAR-T cell therapy, patients can relapse due to antigen escape, 'on-target, off-tumour' toxicity, and an immunosuppressive tumour microenvironment. As a result, this review examines the application of CAR-T therapies including the current FDA-approved drugs and results from clinical trials, the limitations and difficulties associated with CAR-T cell therapy for haematological malignancies, and the prospects for this breakthrough therapy.

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