A Review on Anti-CD19 CAR T Therapy against B-Cell Malignancies and Future Implications

Abstract

This review examines CAR T CD19 immunotherapy, a newly FDA approved targeted therapy for B-Cell Acute Lymphoblastic Leukemia treatment. This therapy utilizes modified T cells from the patient's immune system, engineered to possess an anti-CD19 receptor that can recognize the specific CD19 antigen expressed on the surface of malignant B-lymphocytes. Using this highly individualized treatment, cancer types with a high rate of metastasis or relapse can be treated by the targeted nature of this therapy. The review aims to summarize the process through which CAR T was developed, from its inception to FDA approval. The material examined is current until March 2019 and explores the mechanisms and management of CAR T cell toxicity experienced by patients undergoing treatment. Clinical trials from respective stages of development are also detailed and summarized. The viable treatment options for patients suffering from B-cell acute lymphoblastic leukemia (B-ALL) are outlined. Despite the promising remission rates of CAR T therapy, its accessibility is limited due to current cost of treatment. With advancements in technology and improved understanding of immune-based therapies, it is possible that this method  can become a more viable and affordable treatment option for patients in the future.