Cellular therapy for hematologic malignancies is a rapidly evolving field, with new iterations of novel constructs being developed at a rapid pace. Since the initial reports of chimeric antigen receptor T cell (CAR T cell)success in CD19+ B cell malignancies, multiple clinical trials of CAR T cell therapy directed to CD19 have led to the approval of this therapy by the FDA and the European Medicines Agency for specific indications. Despite strikingly similar efficacy, investigators at multiple centers participating in these studies have observed the nuances of each CAR T cell product, including variability in manufacturing, availability, and toxicity profiles. Here we review state-of-the-art clinical data on CD19-directed CAR T cell therapies in B cell hematologic malignancies, advances made in understanding and modeling associated toxicities, and several exciting advances and creative solutions for overcoming challenges with this therapeutic modality.

血液恶性肿瘤的细胞治疗是一个快速发展的领域，新结构的新迭代正在快速开发。自从首次报道嵌合抗原受体 T 细胞 (CAR T 细胞) 在 CD19+ B 细胞恶性肿瘤中取得成功以来，针对 CD19 的 CAR T 细胞疗法的多项临床试验已导致该疗法获得 FDA 和欧洲药品管理局的批准具体指示。尽管功效惊人相似，参与这些研究的多个中心的研究人员观察到了每种 CAR T 细胞产品的细微差别，包括制造、可用性和毒性特征的差异。在这里，我们回顾了 B 细胞血液恶性肿瘤中 CD19 导向的 CAR T 细胞疗法的最新临床数据、在理解和建模相关毒性方面取得的进展，以及克服这种治疗方式挑战的一些令人兴奋的进展和创造性解决方案。