Application of CAR-T Therapy in Pediatric Oncohematology

The implementation of CAR-T cell therapy, using autologous T lymphocytes with a chimeric antigen receptor, marks a significant advancement in treating pediatric hematologic malignancies, particularly precursor B-cell acute lymphoblastic leukemia (pB-ALL). Although conventional therapy achieves lasting remission in 80-90% of pB-ALL cases, CAR-T therapy offers a promising option for the 10-20% of children with chemo-resistant or relapsed forms, including post-allogeneic hematopoietic stem cell transplantation relapses. CAR-T therapy is also effective for Philadelphia-positive ALL and relapsed or refractory B-cell lymphomas. Its success in B-cell malignancies has spurred research into its use for T-cell ALL, acute myeloid leukemia, and certain central nervous system tumors. Ongoing clinical trials are assessing the safety and efficacy of allogeneic CAR-T therapy in children with pB-ALL.