T-cell acute lymphoblastic leukemia (T-ALL), a form of T-cell malignancy, is a typically aggressive hematological malignancy with high rates of disease relapse and a poor prognosis. Current guidelines do not recommend any specific treatments for these patients, and only allogeneic stem cell transplant, which is associated with potential risks and toxicities, is a curative therapy. Recent clinical trials showed that immunotherapies, including monoclonal antibodies, checkpoint inhibitors, and CAR T therapies, are successful in treating hematologic malignancies. CAR T cells, which specifically target the B-cell surface antigen CD19, have demonstrated remarkable efficacy in the treatment of B-cell acute leukemia, and some progress has been made in the treatment of other hematologic malignancies. However, the development of CAR T-cell immunotherapy targeting T-cell malignancies appears more challenging due to the potential risks of fratricide, T-cell aplasia, immunosuppression, and product contamination. In this review, we discuss the current status of and challenges related to CAR T-cell immunotherapy for T-ALL and review potential strategies to overcome these limitations.

中文翻译：

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CAR T 细胞免疫疗法治疗 T-ALL：挑战与机遇

T细胞急性淋巴细胞白血病（T-ALL）是T细胞恶性肿瘤的一种形式，是一种典型的侵袭性血液恶性肿瘤，疾病复发率高，预后不良。目前的指南不建议对这些患者进行任何特定的治疗，只有具有潜在风险和毒性的同种异体干细胞移植才是一种治疗方法。最近的临床试验表明，包括单克隆抗体、检查点抑制剂和 CAR T 疗法在内的免疫疗法在治疗血液恶性肿瘤方面取得了成功。 CAR T细胞特异性靶向B细胞表面抗原CD19，在治疗B细胞急性白血病方面表现出显着疗效，在治疗其他血液恶性肿瘤方面也取得了一定进展。然而，由于存在自相残杀、T细胞再生障碍、免疫抑制和产品污染等潜在风险，针对T细胞恶性肿瘤的CAR T细胞免疫疗法的开发显得更具挑战性。在这篇综述中，我们讨论了 CAR T 细胞免疫疗法治疗 T-ALL 的现状和挑战，并回顾了克服这些局限性的潜在策略。