CAR-T TECHNOLOGY IN THE MANAGEMENT OF ACUTE LYMPHOBLASTIC LEUKEMIA OF T-CELLS: CHALLENGES AND CLINICAL PERSPECTIVES

Abstract

 T-cell acute lymphoblastic leukemia is a type of cancer that affects T-cells and is one of the most common in oncological pediatrics. It basically consists of the uncontrolled proliferation of hematopoietic progenitor cells and can become a very aggressive tumor in some cases. However, the usage of the "base editing" technique can subdue the disease and lead to remission in patients who had no reaction to conventional treatments - such as chemotherapy and bone marrow transplant. This work introduces “CAR-T" therapy in the treatment of T-cell acute lymphoblastic leukemia in patients refractory to conventional methods. In that way, this study performed a literature review with international papers dated from 1995 to 2022 found on PubMed, Scielo, and MedLine platforms; the search on this platform used mainly the terms T-cell acute lymphoblastic leukemia, CAR-T, CRISPR, and LLA. As results,  ALL is a disease that mostly affects children, characterized by an abundance of immature lymphoid cells in the bone marrow and blood, which are generated by a genetic dysfunction that triggers unbridled cell proliferation and hinders the normalized production of leukocytes, erythrocytes, and platelets. Treatment led to the remission of T-ALL in a teenager in the United Kingdom.  T lymphocytes from a healthy donor were used, which were genetically modified to fight leukemia. Therefore, the modified T-cells fought the tumor lymphocytes and the patient achieved remission. In conclusion, since the use of base editing technique led to the total remission of the leukemia in the patient, it becomes clear that it demonstrates to be a technology with several positive implications; in this aspect, the development of further research in the area that aims to improve and possibly expand the use of the technology used for other types of leukemia is encouraged.